A Retrospective Study into Causes and Treatments of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Iranian Patients

Aims: Stevens-Johnson syndrome and toxic epidermal necrolysis are serious severe cutaneous adverse reactions with high mortality and morbidity induced by medications. In this cross sectional study, we investigated, suspected drugs, and potential treatments of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis. Methods: A cross- sectional descriptive study was conducted on 60 patients admitted with a diagnosis of Stevens-Johnson Syndrome (47 patients) or Toxic Epidermal Necrolysis (13 patients). Except for the therapeutic procedure, data related to pharmacological causes and treatment was obtained from electronic medical records. They were treated daily with either co-administration of intravenous immunoglobulin (1-2mg/kg) and corticosteroid (Prednisolone Forte 1-2mg/kg; maximum 60mg/kg) or exclusive corticosteroid. Finding: Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis were more frequent among females (56.7%) and young people (73.4%). Sepsis was observed in 11.8% of Stevens-Johnson Syndrome patients treated with intravenous immunoglobulin and corticosteroid (mean hospitalization days 2.2±0.6) but not in those who were treated with a corticosteroid (mean hospitalization days 1.6±0.5 days), though all Stevens-Johnson Syndrome patients improved after treatment. In Toxic Epidermal Necrolysis patients, 76.9% of the them showed sepsis that received intravenous immunoglobulin and corticosteroid. The mortality rate was 5%. Antibiotics and anticonvulsant drugs were found to be the main causes of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis. Conclusion: Either intravenous immunoglobulin and corticosteroid or corticosteroid treatments seem to be effective for Stevens-Johnson Syndrome improvement. Potential drug Causes of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis included Antibiotics and anticonvulsant drugs.