Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 19:15:1979-1990.
doi: 10.2147/CCID.S378106. eCollection 2022.

Effectiveness and Safety of Early Short-Course, Moderate- to High-Dose Glucocorticoids for the Treatment of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: A Retrospective Study

Zhenzhen Ye #  1 , Chunting Li #  1 , Hua Zhang  2 , Chunlei Zhang  1 , Xueyan Lu  1
Affiliations

Effectiveness and Safety of Early Short-Course, Moderate- to High-Dose Glucocorticoids for the Treatment of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: A Retrospective Study

Zhenzhen Ye et al. Clin Cosmet Investig Dermatol. .

Abstract

Objective: To summarise the clinical characteristics of patients with Stevens-Johnson syndrome/toxic epidermal necrolysis syndrome (SJS/TEN) and analyse the efficacy and safety of systemic glucocorticoid therapy.

Methods: This study was a retrospective study of 56 patients with SJS/TEN who had been systematically treated with glucocorticoids in the dermatology ward of Peking University Third Hospital from 2010 to 2020. The clinical characteristics, treatment regimen, effects on underlying diseases, incidence and outcome of hormone-related adverse reactions and skin lesion prognosis were summarised and analysed for each patient.

Results: ① The allergenic drugs were found to be antibiotics (31.51%), antipyretic and analgesics (21.92%), traditional Chinese medicines and health products (15.07%) and neuropsychiatric drugs (13.70%). ② Based on the 56 patients' scores of toxic epidermal necrosis at admission, the actual mortality rate was 1.8% (1/56), which was significantly lower than the average expected mortality rate of 15.0% (P = 0.032; standardised mortality ratio = 0.13; 95% confidence interval: 0.00-0.53). ③ A total of 33 patients (58.9%) had underlying diseases, of which 10 patients (30.3%) had underlying diseases that fluctuated during treatment but stabilised after symptomatic treatment. ④ During treatment, 73.2% (41/56) of patients had complications that may have been related to systemic glucocorticoids; 97.6% (40/41) had mild symptoms, and 92.7% (38/41) had improved/recovered complications at the time of discharge.

Conclusion: ① Antibiotics are still the most common sensitising drugs, and traditional Chinese medicine and health products are also common sensitising drugs. ② Early systemic application of medium- to high-dose glucocorticoids is effective in the treatment of SJS/TEN, and it is beneficial in reducing mortality. ③ The short-term application of medium- to high-dose hormone therapy for SJS/TEN has little effect on underlying diseases. The related complications are mostly mild, and the treatment is safe.

Keywords: SCORTEN; Stevens–Johnson syndrome; glucocorticoid-related complications; toxic epidermal necrolysis; treatment.

PubMed Disclaimer

Conflict of interest statement

All of the authors had no personal, financial, commercial, or academic conflicts of interest separately.

Figures

Figure 1
Figure 1
Photos before and after treatment: (A) (SJS), (B) (SJS/TEN overlapping), (C) (TEN).
See this image and copyright information in PMC

References

    1. Estrella-Alonso A, Aramburu JA, González-Ruiz MY, Cachafeiro L, Sánchez MS, Lorente JA. Toxic epidermal necrolysis: a paradigm of critical illness. Rev Bras Ter Intensiva. 2017;29(4):499–508. doi:10.5935/0103-507X.20170075 - DOI - PMC - PubMed
    1. White KD, Abe R, Ardern-Jones M, et al. SJS/TEN 2017: building multidisciplinary networks to drive science and translation. J Allergy Clin Immunol Pract. 2018;6(1):38–69. doi:10.1016/j.jaip.2017.11.023 - DOI - PMC - PubMed
    1. Yang MS, Lee JY, Kim J, et al. Incidence Of Stevens-Johnson syndrome and toxic epidermal necrolysis: a nationwide population-based study using national health insurance database in Korea. PLoS One. 2016;11(11):e0165933. doi:10.1371/journal.pone.0165933 - DOI - PMC - PubMed
    1. Creamer D, Walsh SA, Dziewulski P, et al. U.K. guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults 2016. Br J Dermatol. 2016;174(6):1194–1227. doi:10.1111/bjd.14530 - DOI - PubMed
    1. Research Center for Adverse Drug Reactions, Dermatology and Venereology Branch of Chinese Medical Association. Expert consensus on diagnosis and treatment of Stevens-Johnson syndrome/toxic epidermal necrolysis. Chin J Dermatol. 2021;54(05):376–381.