Epidemiology of StevenseJohnson syndrome and toxic epidermal necrolysis in Southeast Asia

StevenseJohnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe life-threatening reactions characterized by epidermal detachment and mucositis. These reactions are predominantly drug-related. Although a wide spectrum of medications have been reported to be causal in these reactions, the international caseecontrol SCAR (severe cutaneous adverse reactions)1 and EuroSCAR2 studies have shown that in Europe, the majority of reactions can be attributed to a group of high-risk drugs such as allopurinol, carbamazepine, phenytoin, lamotrigine, oxicam nonsteroidal anti-inflammatory drugs, sulfonamide antibiotics, and nevirapine. In parallel, several epidemiological studies (both retrospective and prospective) have been conducted in Europe looking at the incidence of SJS/TEN. Initial hospital-based retrospective studies have estimated the incidence of TEN in France and Germany to be 1.2 and 0.9 cases/million/year, respectively.3,4 Newer prospective population-based studies based on the German registry have