Sanmarkan Abarna Devi, Sori Tukaram, Thappa Devinder Mohan, Jaisankar T J
Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry - 605 006, India.
Indian J Dermatol. 2011 Jan;56(1):25-9. doi: 10.4103/0019-5154.77546.
Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), are the acute emergencies in dermatology practice. Prompt diagnosis and management may reduce the morbidity and mortality in SJS/TEN patients. Early identification of the offending drug is necessary for early withdrawal and to prevent the recurrences of such a devastating illness.
To study the demography, offending agents, clinical and laboratory features, treatment, complications, morbidity and mortality of SJS/TEN in our hospital.
In this retrospective study, we reviewed the medical records of SJS, TEN, SJS/TEN overlap of inpatients over a period of 10 years
Maximum number of SJS/TEN cases were in the age group of 11-30 years. Males predominated in the SJS group with a ratio of 1.63:1, whereas females predominated the TEN group with a ratio of 1:2.57.Nonsteroidal anti-inflammatory drugs (NSAIDs) were the commonest group of drugs among the SJS group in 5/21 patients (23.8%). Antimicrobials were the commonest group of drugs causing TEN in 11/25 patients (44%). Mucosal lesions preceded the onset of skin lesions in nearly 50%. Our study had one patient each of SJS/TEN due to amlodipine and Phyllanthus amarus, an Indian herb. The most common morbidity noted in our study was due to ocular sequelae and sepsis leading to acute renal failure respectively. Kaposi's varicelliform eruption was found in three of our patients.
Antimicrobials and NSAIDS are the common offending agents of SJS/TEN in our study.
史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是皮肤科临床中的急性急症。及时诊断和治疗可降低SJS/TEN患者的发病率和死亡率。尽早识别致病药物对于早期停药及预防这种严重疾病的复发很有必要。
研究我院SJS/TEN患者的人口统计学特征、致病因素、临床及实验室特征、治疗、并发症、发病率和死亡率。
在这项回顾性研究中，我们回顾了10年间住院的SJS、TEN、SJS/TEN重叠患者的病历。
SJS/TEN病例数最多的年龄组为11至30岁。SJS组男性居多，比例为1.63:1，而TEN组女性居多，比例为1:2.57。非甾体抗炎药（NSAIDs）是SJS组中最常见的致病药物组，21例患者中有5例（23.8%）。抗菌药物是导致TEN的最常见药物组，25例患者中有11例（44%）。近50%的患者黏膜病变先于皮肤病变出现。我们的研究中有1例SJS/TEN患者分别由氨氯地平和印度草药苦味叶下珠引起。我们研究中最常见的并发症分别是眼部后遗症和败血症导致急性肾衰竭。3例患者出现了卡波西水痘样疹。
在我们的研究中，抗菌药物和NSAIDs是SJS/TEN最常见的致病因素。
