Causes and treatments of Stevens - Johnson syndrome and toxic epidermal necrolysis in Iranian patients

Aims: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious severe cutaneous adverse reactions with high mortality and morbidity induced by medications. In this cross sectional study, we investigated, suspected drugs, and potential treatments of SJS/TEN. Methods: A cross- sectional descriptive study was conducted on 60 patients admitted with a diagnosis of Stevens-Johnson syndrome (47 patients) or toxic epidermal necrolysis (13patients). Except for the therapeutic procedure, data related to pharmacological causes and treatment was obtained from electronic medical records. They were treated daily with either co-administration of intravenous immunoglobulin (IVIG, 1-2 mg/kg) and corticosteroid (Prednisolone Forte 1-2 mg/kg; maximum 60 mg/kg) or exclusive corticosteroid. Finding: SJS/TEN were more frequent among females (56.7%) and young people (73.4%). Sepsis was observed in 11.8% of SJS patients treated with IVIG+corticosteroid (mean hospitalization days 2.2±0.6) but not in those who were treated with a corticosteroid (mean hospitalization days 1.6± 0.5 days), though all SJS patients improved after treatment. In TEN patients, 76.9% of the patients received IVIG+corticosteroid showed sepsis. The mortality rate was 5% among SJS/TEN patients. Antibiotics and anticonvulsant drugs were found to be the main causes of SJS/TEN. Conclusions: Either IVIG+corticosteroid or corticosteroid treatments seem to be effective for SJS improvement. Potential drug Causes of SJS and TEN included Antibiotics and anticonvulsant drugs.