Abou-Taleb Doaa A E, El-Sayed Ahmed M, Ghabesha Ayad A, Hassan Sahar B
Faculty of Medicine, Department of Dermatology, Venereology, and Andrology, Assiut University, Assiut, Egypt.
Faculty of Pharmacy, Department of Pharmaceutics, Assiut University, Assiut, Egypt.
Dermatol Ther. 2020 Nov;33(6):e14176. doi: 10.1111/dth.14176. Epub 2020 Sep 7.
Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and overlap SJS/TEN are life-threatening diseases that are most frequently caused by drugs. Much debate remains about the role of systemic corticosteroids (SCs) in their treatment. Our aim to determine the incidence, causative drugs, the role and side effects of SCs in severe cutaneous adverse reactions (SCARs), in Assiut University Hospital (AUH). Patients This study was conducted in Department of Dermatology at AUH, from 2012 to 2017. All patients with SJS, overlap SJS/TEN and TEN admitted during this period were included in the study. Eighty-three patients with SCARs were included in this study. The most common type was SJS (67.5%). The incidence ranged from 1.7% in 2012 to 7.7% in 2017. Carbamazepine, valproic acid, lamotrigine, diclofenac sodium, and flucloxacillin-amoxicillin were the most common causative drugs. The most common side effects of SCs were peptic ulcer (55.5%) and hypertension (51.8%). The mortality rate in patients treated with SCs was 100% in TEN, 33.3% in overlap SJS/TEN and 16.3% in SJS. The patients of SCARs must be aware of the causative drugs and must never be re-administered. SCs in treatment of SCARs may increase the complications and the mortality rate.
史蒂文斯-约翰逊综合征(SJS)、中毒性表皮坏死松解症(TEN)以及重叠型SJS/TEN是危及生命的疾病,最常见的病因是药物。关于全身性皮质类固醇(SCs)在其治疗中的作用仍存在诸多争议。我们旨在确定阿斯尤特大学医院(AUH)中严重皮肤不良反应(SCARs)的发病率、致病药物、SCs的作用及副作用。患者本研究于2012年至2017年在AUH皮肤科进行。在此期间收治的所有SJS、重叠型SJS/TEN和TEN患者均纳入研究。本研究纳入了83例SCARs患者。最常见的类型是SJS(67.5%)。发病率从2012年的1.7%到2017年的7.7%不等。卡马西平、丙戊酸、拉莫三嗪、双氯芬酸钠和氟氯西林-阿莫西林是最常见的致病药物。SCs最常见的副作用是消化性溃疡(55.5%)和高血压(51.8%)。接受SCs治疗的患者死亡率在TEN中为100%,在重叠型SJS/TEN中为33.3%,在SJS中为16.3%。SCARs患者必须了解致病药物,且绝不能再次使用。SCs治疗SCARs可能会增加并发症和死亡率。