Pasieczna Wioletta, Zaj Natalia, Jerzak Marika, Ruszel Karol P, Bodajko-Grochowska Anna, Wawryk-Gawda Ewelina, Opoka-Winiarska Violetta
Students' Scientific Group of Department of Pediatric Pulmonology and Rheumatology, Medical University of Lublin, Lublin, Poland.
Collegium Medicum, The Mazovian Academy in Płock, Płock, Poland.
Med Sci Monit. 2025 Aug 16;31:e948373. doi: 10.12659/MSM.948373.
BACKGROUND Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe skin reactions with unclear pathogenesis and lack of established diagnostic and therapeutic protocols. This study investigates the triggering factors, diagnostic challenges, and therapeutic approaches in pediatric patients with necrotic skin reactions. MATERIAL AND METHODS A retrospective analysis of the medical records of 13 patients was performed. The diagnosis of necrotic skin reactions was based on medical history and clinical manifestation. Using Lund-Bowder table, the percentage of skin involvement was calculated. We analyzed demographic data, length of hospitalization, prodromal symptoms, percentage of affected skin, mucous membranes involvement, triggering factors, time form exposure to the causative agent to the onset of symptoms and treatments used. RESULTS The average length of hospitalization was 11.2±4.96 days. Prodromal symptoms were noticed in 7 patients. Lesions of mucous membranes and skin were observed in 8 children, only mucous membranes in 3, only skin in 2. A probable trigger factor was identified in 11 cases, in 2 cases the causative agent was not identified. The treatment with antibiotic and anti-inflammatory drugs resulted in improvement in 12 patients. CONCLUSIONS SJS and TEN can arise as serious complications from infections or medications in children. Prompt identification of causative agents and early intervention with tailored treatments are essential to improve outcomes and prevent lasting complications. Our findings suggest that antibiotics and anti-inflammatory drugs are effective in managing these conditions, though further research is needed to refine therapeutic strategies in the pediatric context.
史蒂文斯 - 约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是严重的皮肤反应，其发病机制尚不清楚，且缺乏既定的诊断和治疗方案。本研究调查了患有坏死性皮肤反应的儿科患者的触发因素、诊断挑战和治疗方法。
对13例患者的病历进行回顾性分析。坏死性皮肤反应的诊断基于病史和临床表现。使用伦德 - 鲍德表计算皮肤受累百分比。我们分析了人口统计学数据、住院时间、前驱症状、受累皮肤百分比、黏膜受累情况、触发因素、从接触病原体到症状发作的时间以及所采用的治疗方法。
平均住院时间为11.2±4.96天。7例患者出现前驱症状。8例儿童观察到黏膜和皮肤病变，3例仅黏膜受累，2例仅皮肤受累。11例患者确定了可能的触发因素，2例未确定病原体。12例患者使用抗生素和抗炎药物治疗后病情改善。
SJS和TEN可能作为儿童感染或药物引起的严重并发症出现。及时识别病原体并采用针对性治疗进行早期干预对于改善预后和预防长期并发症至关重要。我们的研究结果表明，抗生素和抗炎药物在治疗这些病症方面有效，不过在儿科背景下还需要进一步研究以完善治疗策略。
