Wanat Karolyn A, Anadkat Milan J, Klekotka Paul A
Division of Dermatology, Washington University School of Medicine, St Louis, Missouri 63110, USA.
J Am Acad Dermatol. 2009 Apr;60(4):589-94. doi: 10.1016/j.jaad.2008.11.884. Epub 2009 Feb 13.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and severe cutaneous adverse reactions to medications and infections.
We sought to determine whether a seasonal variation to SJS and TEN exists and to define the characteristics in our tertiary referral hospital.
A retrospective chart review of 50 patients from 1995 through 2007 was performed and statistically analyzed.
The most common medication implicated as a cause of SJS/TEN was trimethoprim-sulfamethoxazole (TMX) (26%). A seasonal trend, favoring springtime, was observed for the total number of cases of SJS and TEN (P = .34). There was a significant increase in cases due to TMX (53%) occurring in spring compared to other seasons (P = .002). These patients were significantly younger (37.8 +/- 13.7) than other patients with SJS and TEN (53.7 +/- 16.4) (P = .003). Their overall mortality (1 death) and average SCORTEN value (1.62 +/- 1.6) was also significantly lower (P = .04 and 0.03, respectively). Based on outpatient pharmacy records, there was no increase in TMX prescriptions filled during the spring.
The study was limited by reliance on chart data, the use of inpatient records, and number of patients.
A seasonal variation in SJS and TEN caused by TMX affecting younger patients may exist.
史蒂文斯 - 约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是罕见且严重的药物和感染引起的皮肤不良反应。
我们试图确定SJS和TEN是否存在季节性变化，并明确我们三级转诊医院中的相关特征。
对1995年至2007年期间的50例患者进行回顾性病历审查并进行统计分析。
被认为是SJS/TEN病因的最常见药物是甲氧苄啶 - 磺胺甲恶唑（TMX）（26%）。观察到SJS和TEN病例总数存在季节性趋势，春季更为常见（P = 0.34）。与其他季节相比，春季因TMX导致的病例显著增加（53%）（P = 0.002）。这些患者明显比其他SJS和TEN患者年轻（37.8±13.7）（53.7±16.4）（P = 0.003）。他们的总体死亡率（1例死亡）和平均SCORTEN值（1.62±1.6）也显著更低（分别为P = 0.04和0.03）。根据门诊药房记录，春季TMX处方量没有增加。
该研究受限于对病历数据的依赖、住院记录的使用以及患者数量。
可能存在由TMX引起的SJS和TEN的季节性变化，且影响年轻患者。
