PMID- 33848012
OWN - NLM
STAT- MEDLINE
DCOM- 20210712
LR  - 20210712
IS  - 1365-4632 (Electronic)
IS  - 0011-9059 (Linking)
VI  - 60
IP  - 8
DP  - 2021 Aug
TI  - Stevens-Johnson syndrome and toxic epidermal necrolysis in a referral center in 
      Taiwan.
PG  - 964-972
LID - 10.1111/ijd.15586 [doi]
AB  - BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) 
      are potentially fatal adverse drug reactions. The characteristics of these 
      diseases are changing with the use of novel drugs, posing new challenges to 
      doctors. We aimed to review recent SJS/TEN cases in order to assist general 
      practitioners with timely diagnosis and correct management. METHODS: We conducted 
      a retrospective chart review of SJS/TEN patients in a referral center in Taiwan 
      from 2009 to 2019. We included 24 patients' charts and analyzed demographic data, 
      medication histories, clinical courses, human leukocyte antigen (HLA) alleles, 
      and long-term complications. RESULTS: The average age was 63.4 years, and the 
      average toxic epidermal necrolysis-specific severity of illness score was 1.9. 
      The most common culprit drug was carbamazepine (33.3%), followed by antibiotics 
      (12.5%) and nonsteroidal anti-inflammatory drugs (8.3%). Two cases were caused by 
      immune checkpoint inhibitors, and one of them had a long latency of 210 days. 
      Three out of the four patients carrying HLA-B*15:02 had carbamazepine-induced 
      SJS/TEN. All patients were treated with systemic corticosteroids in the acute 
      stage of the diseases. The length of in-hospital stay did not correlate with the 
      average daily dose of corticosteroids. The overall mortality rate was 4.2%, and 
      the disease-specific mortality rate was 0%. CONCLUSIONS: The most common culprit 
      drug was carbamazepine, which had strong association with HLA-B*15:02. There was 
      no statistically significant correlation between in-hospital stay and the average 
      daily dose of corticosteroids. Immune checkpoint inhibitor-related SJS/TEN may 
      have an extended latent period.
CI  - (c) 2021 the International Society of Dermatology.
FAU - Hsu, Ting-Jung
AU  - Hsu TJ
AUID- ORCID: 0000-0002-1145-6535
AD  - Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung City, Taiwan.
FAU - Yeh, Hsu-Hang
AU  - Yeh HH
AD  - Chen Chia-Wei Dermatology, Kaohsiung City, Taiwan.
FAU - Lee, Chih-Hung
AU  - Lee CH
AD  - Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung City, Taiwan.
FAU - Liu, Kwei-Lan
AU  - Liu KL
AD  - Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung 
      University College of Medicine, Kaohsiung City, Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20210413
PL  - England
TA  - Int J Dermatol
JT  - International journal of dermatology
JID - 0243704
RN  - 0 (Anticonvulsants)
SB  - IM
MH  - Anticonvulsants
MH  - Humans
MH  - Middle Aged
MH  - Referral and Consultation
MH  - Retrospective Studies
MH  - *Stevens-Johnson Syndrome/diagnosis/epidemiology/etiology
MH  - Taiwan/epidemiology
EDAT- 2021/04/14 06:00
MHDA- 2021/07/13 06:00
CRDT- 2021/04/13 12:22
PHST- 2021/01/05 00:00 [revised]
PHST- 2020/07/31 00:00 [received]
PHST- 2021/04/14 06:00 [pubmed]
PHST- 2021/07/13 06:00 [medline]
PHST- 2021/04/13 12:22 [entrez]
AID - 10.1111/ijd.15586 [doi]
PST - ppublish
SO  - Int J Dermatol. 2021 Aug;60(8):964-972. doi: 10.1111/ijd.15586. Epub 2021 Apr 13.