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Open Access Profile and Pattern of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in a General Hospital in Singapore: Treatment Outcomes

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, but potentially life-threatening, reactions to medications. Both conditions have significant morbidity and mortality. The aim of this study was to document the epidemiological features, aetiologies, treatment and clinical outcomes of retrospectively reviewed data of all patients with SJS or TEN treated from January 2004 to November 2010 in a general hospital. There were 18 cases of SJS, seven cases of SJS/TEN overlap and three cases of TEN. Mean age was 50.6 years, with a range of 13–85 years. The male/female ratio was 1. Drugs accounted for 26 cases; one case was caused by Neisseria gonorrhoea infection. Anti-convulsants (35.7%) were the most common implicated drugs followed by antibiotics (28.5%), non-steroidal anti-inflammatory drugs (NSAIDS) (14.3%), allopurinol (7.1%) and traditional Chinese medication (7.1%). In seven cases, multiple drugs were implicated. Most SJS cases (88%) were treated with corticosteroids, of which 61% were given highdose systemic corticosteroids. No infective complications were observed. Six out of the seven SJS/TEN overlap syndrome and all three TEN cases were given intravenous immunoglobulins. One patient with TEN died. In conclusion, anti-convulsants, especially carbamazepine, were the most frequently implicated drugs, followed by antibiotics and NSAIDS. High-dose corticosteroids were effective in SJS, whereas intra venous immunoglobulin were useful in TEN and SJS/TEN overlap syndrome.

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Keywords: SINGAPORE; STEVENS-JOHNSON SYNDROME; TOXIC EPIDERMAL NECROLYSIS

Document Type: Conference Report

Publication date: January 1, 2012

More about this publication?
  • Acta Dermato-Venereologica is a bi-monthly international peer-reviewed journal for clinical and experimental research in the field of dermatology and venereology.

    It was founded in 1920 by Johan Almqvist and edited during 1936-1969 by Sven Hellerström. Since 1970, the journal has been published for the Society for the Publication of Acta Dermato-Venereologica on a non-profit basis.

    Acta Dermato-Venereologica publishes high-quality manuscripts in English dealing with new observations on basic dermatological and venereological research, as well as clinical investigations. Each volume also features a number of review articles in special areas, as well as short Letters to the Editor to stimulate debate and to disseminate important clinical observations. Acta Dermato-Venereologica has rapid publication times and is amply illustrated with a large number of colour photographs to enhance understanding.

    Acta Dermato-Venereologica covers inter alia:

    • ~ Atopic dermatitis and contact allergy
    • ~ Facial dermatoses and adnexal disorders
    • ~ New treatments
    • ~ Psoriasis and genodermatoses
    • ~ Psychodermatology
    • ~ Sexually transmitted diseases
    • ~ Skin biology and inflammation
    • ~ Skin cancer and pigmentation
    • ~ Skin immunology and lymphoma
    • ~ Urticaria and itch

    Extensive papers, proceedings from congresses and symposia are printed as supplements to the journal. Announcements concerning pertinent dermatological meetings and books received are also published.
    Readership: Doctors and scientists interested in dermatology, skin biology and venereology.

    Acta Dermato-Venereologica has an impact factor of 3.007.

    Issues between 1998 up to 2005 can be found at http://www.medicaljournals.se/acta/content

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