Epidemiological Study of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Retrospective Analysis of Southern Taiwanese Population During 2002 to 2007

Background. Stevens-Johnson syndrome(SJS) and toxic epidermal necrolysis(TEN) are severe adverse drug reaction with potentially life-threatening skin disease. The widely accepted consensus regarding therapy does not exist at present and epidemiological data of Taiwan in recent years is limited. Objective: To evaluate the efficacy of systemic steroid therapy in treatment of SJS and TEN and also analysis the associated epidemiology data. Methods: This study was performed by retrospectively chart review of patients admitted with SJS or TEN in a tertial referral medical center in southern Taiwan between 2002 and 2007. Clinical data including mortality, morbidity, the category of offending drugs and the systemic steroid treatment effects were analyzed. Results: Total 52 patients were included; 10 were classified as TEN and 42 as SJS. Overall mortality is 3.8% and infectious morbidity is 23%. In aspect of causative agents, anticonvulsants (especially carbamazepine) were the most common drugs followed by Non-Steroid Anti-inflammatory Drugs, allopurinol and antibiotics in our series. Early systemic steroid administration may shorten the hospitalization duration than supportive care (p < 0.012) in our study. Conclusion: In our study, early administration of systemic steroids maybe benefits in the forms of inflammation prevention and disease progression. Short-term use to preclude infection morbidity, as well as a tapering dose as soon as possible, is suggested. (Dermatol Sinica 27: 15-26, 2009)