Stevens–Johnson syndrome and toxic epidermal necrolysis in an academic hospital setting: a 5-year retrospective study
Introduction: Toxic epidermal necrolysis and Stevens–Johnson syndrome are acute life-threatening mucocutaneous reactions to drugs. The aims of the study were to identify these drugs and characterize population prone to these reactions. Materials and Methods: Data including demographics, culprit d...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Our Dermatology Online
2016-10-01
|
| Series: | Nasza Dermatologia Online |
| Subjects: | |
| Online Access: | http://www.odermatol.com/issue-in-html/2016-4-2/ |
| _version_ | 1818237118409867264 |
|---|---|
| author | Ewa Stocka-Łabno Natalia Gabzdyl Magdalena Misiak-Galazka Małgorzata Pawłowska-Kisiel Tomasz Łazowski Lidia Rudnicka |
| author_facet | Ewa Stocka-Łabno Natalia Gabzdyl Magdalena Misiak-Galazka Małgorzata Pawłowska-Kisiel Tomasz Łazowski Lidia Rudnicka |
| author_sort | Ewa Stocka-Łabno |
| collection | DOAJ |
| description | Introduction: Toxic epidermal necrolysis and Stevens–Johnson syndrome are acute life-threatening mucocutaneous reactions to drugs. The aims of the study were to identify these drugs and characterize population prone to these reactions.
Materials and Methods: Data including demographics, culprit drug, clinical characteristics, course of disease, treatment given, and therapeutic responses were retrospectively collected from medical records of 31 patients admitted to Department of Dermatology from January 2009 to December 2014.
Results: Drugs most commonly involved in Stevens–Johnson syndrome were antimicrobials: ciprofloxacin, doxycycline, cefuroxime, trimethoprim, amoxicillin, clindamycin, co-trimoxazole (50% of patients) and nonsteroidal anti-inflammatory drugs: ibuprofen, naproxen, metamizole, piroxicam (29% of patients). Drugs involved in toxic epidermal necrolysis were antimicrobials: sulfasalazine, co-trimoxazole, cefuroxime, clindamycin (71% of patients) and anticonvulsants: lamotrigine (29% of patients). The comorbidities’ characteristic for the group of patients affected by toxic epidermal necrolysis were psychiatric and autoimmune disorders. The most common complication was infection. Two patients died and in both cases the cause of death was sepsis.
Conclusion: The study indicates that in observed population drugs with the highest risk of most severe reactions are lamotrigine (anticonvulsant) and antimicrobials (most commonly sulfonamides), therefore it is advisable to consider carefully administration of these drugs, especially to patients with history of autoimmune reactions. |
| first_indexed | 2024-12-12T12:20:40Z |
| format | Article |
| id | doaj.art-9d68aa69560749d3a49923c771be5811 |
| institution | Directory Open Access Journal |
| issn | 2081-9390 |
| language | English |
| last_indexed | 2024-12-12T12:20:40Z |
| publishDate | 2016-10-01 |
| publisher | Our Dermatology Online |
| record_format | Article |
| series | Nasza Dermatologia Online |
| spelling | doaj.art-9d68aa69560749d3a49923c771be58112022-12-22T00:24:41ZengOur Dermatology OnlineNasza Dermatologia Online2081-93902016-10-017438138410.7241/ourd.20164.104Stevens–Johnson syndrome and toxic epidermal necrolysis in an academic hospital setting: a 5-year retrospective studyEwa Stocka-Łabno0Natalia Gabzdyl1Magdalena Misiak-Galazka2Małgorzata Pawłowska-Kisiel3Tomasz Łazowski4Lidia Rudnicka51Department of Dermatology, Medical University of Warsaw, Warsaw, Poland1Department of Dermatology, Medical University of Warsaw, Warsaw, Poland1Department of Dermatology, Medical University of Warsaw, Warsaw, Poland1Department of Dermatology, Medical University of Warsaw, Warsaw, Poland2Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland1Department of Dermatology, Medical University of Warsaw, Warsaw, PolandIntroduction: Toxic epidermal necrolysis and Stevens–Johnson syndrome are acute life-threatening mucocutaneous reactions to drugs. The aims of the study were to identify these drugs and characterize population prone to these reactions. Materials and Methods: Data including demographics, culprit drug, clinical characteristics, course of disease, treatment given, and therapeutic responses were retrospectively collected from medical records of 31 patients admitted to Department of Dermatology from January 2009 to December 2014. Results: Drugs most commonly involved in Stevens–Johnson syndrome were antimicrobials: ciprofloxacin, doxycycline, cefuroxime, trimethoprim, amoxicillin, clindamycin, co-trimoxazole (50% of patients) and nonsteroidal anti-inflammatory drugs: ibuprofen, naproxen, metamizole, piroxicam (29% of patients). Drugs involved in toxic epidermal necrolysis were antimicrobials: sulfasalazine, co-trimoxazole, cefuroxime, clindamycin (71% of patients) and anticonvulsants: lamotrigine (29% of patients). The comorbidities’ characteristic for the group of patients affected by toxic epidermal necrolysis were psychiatric and autoimmune disorders. The most common complication was infection. Two patients died and in both cases the cause of death was sepsis. Conclusion: The study indicates that in observed population drugs with the highest risk of most severe reactions are lamotrigine (anticonvulsant) and antimicrobials (most commonly sulfonamides), therefore it is advisable to consider carefully administration of these drugs, especially to patients with history of autoimmune reactions.http://www.odermatol.com/issue-in-html/2016-4-2/Stevens-Johnson syndrome; Toxic epidermal necrolysis; Adverse drug reaction |
| spellingShingle | Ewa Stocka-Łabno Natalia Gabzdyl Magdalena Misiak-Galazka Małgorzata Pawłowska-Kisiel Tomasz Łazowski Lidia Rudnicka Stevens–Johnson syndrome and toxic epidermal necrolysis in an academic hospital setting: a 5-year retrospective study Nasza Dermatologia Online Stevens-Johnson syndrome; Toxic epidermal necrolysis; Adverse drug reaction |
| title | Stevens–Johnson syndrome and toxic epidermal necrolysis in an academic hospital setting: a 5-year retrospective study |
| title_full | Stevens–Johnson syndrome and toxic epidermal necrolysis in an academic hospital setting: a 5-year retrospective study |
| title_fullStr | Stevens–Johnson syndrome and toxic epidermal necrolysis in an academic hospital setting: a 5-year retrospective study |
| title_full_unstemmed | Stevens–Johnson syndrome and toxic epidermal necrolysis in an academic hospital setting: a 5-year retrospective study |
| title_short | Stevens–Johnson syndrome and toxic epidermal necrolysis in an academic hospital setting: a 5-year retrospective study |
| title_sort | stevens johnson syndrome and toxic epidermal necrolysis in an academic hospital setting a 5 year retrospective study |
| topic | Stevens-Johnson syndrome; Toxic epidermal necrolysis; Adverse drug reaction |
| url | http://www.odermatol.com/issue-in-html/2016-4-2/ |
| work_keys_str_mv | AT ewastockałabno stevensjohnsonsyndromeandtoxicepidermalnecrolysisinanacademichospitalsettinga5yearretrospectivestudy AT nataliagabzdyl stevensjohnsonsyndromeandtoxicepidermalnecrolysisinanacademichospitalsettinga5yearretrospectivestudy AT magdalenamisiakgalazka stevensjohnsonsyndromeandtoxicepidermalnecrolysisinanacademichospitalsettinga5yearretrospectivestudy AT małgorzatapawłowskakisiel stevensjohnsonsyndromeandtoxicepidermalnecrolysisinanacademichospitalsettinga5yearretrospectivestudy AT tomaszłazowski stevensjohnsonsyndromeandtoxicepidermalnecrolysisinanacademichospitalsettinga5yearretrospectivestudy AT lidiarudnicka stevensjohnsonsyndromeandtoxicepidermalnecrolysisinanacademichospitalsettinga5yearretrospectivestudy |