Stevens-Johnson syndrome and toxic epidermal necrolysis in Asian children

Background

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but severe drug reactions. There have been few reviews of SJS and TEN in children.

Objectives

To evaluate the clinical profile and treatment outcomes of 15 pediatric patients with SJS or TEN.

Methods

We retrospectively reviewed the case notes of all patients diagnosed with SJS or TEN admitted to a tertiary care pediatric hospital from 2001 to 2006.

Results

We identified 13 cases of SJS, 1 case of SJS/TEN overlap and 1 case of TEN. Four patients were treated with intravenous immunoglobulin (IVIg), 5 patients were treated with systemic corticosteroids, and 6 patients were treated with supportive therapy only. The time to cessation of progression of disease was not significantly different in these 3 groups of patients. The duration of hospital stay was longer for patients treated with IVIG compared with those treated with systemic corticosteroids or supportive therapy. The only death was the patient with TEN treated with IVIG.

Limitations

This was a retrospective study with a very small number of patients.

Conclusion

The use of intravenous immunoglobulins or systemic corticosteroids did not improve the outcome of SJS and TEN.

Key words: corticosteroids, intravenous immunoglobulins, Stevens-Johnson syndrome, toxic epidermal necrolysis

Abbreviations used: ALT, alanine transferase, BSA, body surface area, CRP, C-reactive protein, ESR, erythrocyte sedimentation rate, IVIG, intravenous immunoglobulin, SJS, Stevens-Johnson syndrome, TEN, toxic epidermal necrolysis