Department of Dermatology, Singapore General Hospital, Singapore.
Department of Dermatology, King's College Hospital, London, U.K.
Br J Dermatol. 2017 Oct;177(4):924-935. doi: 10.1111/bjd.15360. Epub 2017 Sep 22.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse reactions to drugs that cause a life-threatening eruption of mucocutaneous blistering and epithelial sloughing. While the acute complications of SJS/TEN are well described, it is increasingly recognized that survivors may develop delayed sequelae, some of which can be associated with significant morbidity. Studies of long-term SJS/TEN outcomes mostly focus on mucocutaneous and ocular complications. However, other internal organs, such as the respiratory tract and gastrointestinal tract, can be affected. Psychological sequelae are also frequent following the trauma of widespread epidermal necrolysis. An appreciation of the 'chronic' phase of SJS/TEN is needed by clinicians caring for individuals who have survived the acute illness. This review aims to provide an update on the breadth and range of sequelae that can affect patients in the months and years following an acute episode of SJS/TEN.
史蒂文斯-约翰逊综合征(SJS)和中毒性表皮坏死松解症(TEN)是药物引起的严重不良反应,可导致危及生命的黏膜皮肤水疱和上皮脱落。虽然 SJS/TEN 的急性并发症已有详细描述,但越来越多的人认识到幸存者可能会出现迟发性后遗症,其中一些可能与明显的发病率相关。关于 SJS/TEN 长期结局的研究主要集中在黏膜皮肤和眼部并发症上。然而,呼吸道和胃肠道等其他内脏器官也可能受到影响。广泛表皮坏死松解后的创伤也会导致频繁的心理后遗症。对于急性疾病后幸存的个体,临床医生需要了解 SJS/TEN 的“慢性”阶段。本综述旨在提供最新信息,说明在 SJS/TEN 急性发作后的数月和数年内可能影响患者的后遗症的广度和范围。