[Stevens-Johnson syndrome and toxic epidermal necrolysis in a teaching hospital in Lomé, Togo: retrospective study of 89 cases]

Abstract

Objectives: The purpose of this study was to document epidemiological features, outcomes, and aetiologies of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in a teaching hospital in Lomé, Togo.

Method: A retrospective study of patients with SJS/TEN treated from January 2002 to April 2009 in a teaching hospital in Lomé was conducted.

Results: During the study period, 89 patients were treated for SJS/TEN, i.e., SJS in 76 cases, TEN in 9, and overlapping SJS/TEN in 4. Mean age was 30.3 +/- 13.4 years and sex ratio (M/F) was 0.7. Serological testing for HIV was carried out in 75 patients and was positive in 41 (54.6%) including 36 patients with SJS, 3 with TEN and 2 with overlapping SJS/TEN. A total of 9 patients died including 4 with SJS, 4 with TEN and one with overlapping SJS/TEN. Six of the patients who died were HIV-infected. Complications included blindness in 3 cases, moderate dry eye syndrome in 1, vaginal synechiae in 2, synechiae of labial commeasures in 1, and hypertrophic scars in 1. Antibacterial sulphonamides (50.6%) were the most commonly implicated drugs followed by nevirapine (23.6%), non-steroidal anti-inflammatory drugs (5.6%), and anti-epileptic medications (3.4%).

Discussion: Our results also document the high frequency of nevirapine as a new SJS/TEN cause unrelated to antibacterial sulphonamides. With increasing access to HIV medication in sub-Saharan Africa countries, practitioners should take these data into account for patient monitoring.