Cause, clinical course and complications in patients with Stevens- Johnson syndrome and Toxic Epidermal Necrolysis

Toxic epidermal necrolysis (TEN) and Stevens Johnson syndrome (SJS) are diseases that may cause serious complications. This study aims to describe the cause, clinical course and complications in patients admitted with TEN and SJS in two university hospitals in Tehran.

Patients admitted with TEN or SJS in Shohada and Loghman hospitals between 2000 and 2006 were included in the study, and the causes, complications and mortality of these two diseases were documented.

Out of the 59 patients studied, 93% of patients were diagnosed as SJS and 7% with TEN 52.5% were male. 73% of patients were adults and 17% children. Over 80% of patients had received at least one of the two classes of drugs, i.e. antibiotics and/or anticonvulsants. Infectious disease had been diagnosed in 39% of patients and epilepsy in 55%. Next on the list were migraine, head trauma, intracranial hemorrhage and uremia. The mean duration of drug use was 26.5 days. 23.7% of patients had anemia and 15.2% patients had leukopenia. In 11.8% of patients liver transaminases were increased 27.3% had pyuria, 11.8% hematuria, and 10.2% had both pyuria and hematuria.

The study showed that many factors are involved but drug use is the most important factor that causes TEN/SJS.