Stevens-Johnson syndrome and toxic epidermal necrolysis: A review of the clinical experience of a University Hospital (1989-2008)

Background and objectives: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening drug reactions considered to be part of a single spectrum disease. Aim: The aim of this work is to describe the clinical and epidemiological characteristics of the complex SJS/TEN in a reference University Hospital. Patients and methods: Retrospective study of patients diagnosed with SJS/TEN in a Hospital provided with a reference burn unit (1989-2008). Results: We included 71 patients, 34 SJS and 32 TEN. They presented an average of 62.5% of the body surface area affected and 25.9% of epidermal sloughing. Mucosal involvement was present in all of them. The average of suspected drugs were 2.3 per patient, being painkillers, NSAID and antiepileptic drugs the most frequent. Silver sulfadiazine was the topical treatment most frequently used and 90% received systemic steroids. A fatal outcome was present in 20% of the patients. Conclusions: The epidemiological and clinical data were consistent with those of other series. Discontinuation of the offending drug, as well as the early admission to a burn unit are the clues for the management of SJS/TEN. Topical treatment with silver sulfadiazine has shown to be useful and safe. © 2010 Elsevier España.