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. 2025 Apr 21:18:979-988.
doi: 10.2147/CCID.S514590. eCollection 2025.

Understanding the Gap Between Acute Complications and Long-Term Sequelae in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Bandung, West Java, Indonesia: Experience from Two Institutions

Endang Sutedja  1 , Oki Suwarsa  1 , Miranti Pangastuti  1 , Chaerani Pratiwi Firdaus  1 , Reiva Farah Dwiyana  1 , Trustia Rizqandaru  1 , Arief Akhdestira Mustaram  2 , Patriotika Muslima  2 , Ayu Adzani Sabila  1
Affiliations

Understanding the Gap Between Acute Complications and Long-Term Sequelae in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Bandung, West Java, Indonesia: Experience from Two Institutions

Endang Sutedja et al. Clin Cosmet Investig Dermatol. .

Abstract

Introduction: A severe skin reaction called Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) can cause a number of short-term and long-term problems that affect many organ systems.

Objective: To describe acute complications and long-term sequelae in patients with SJS/TEN in two tertiary referral hospitals in West Java.

Methods: A retrospective study was conducted in patients with SJS/TEN treated from January 1st, 2022, to July 31st, 2024, at Dr. Hasan Sadikin General Hospital Bandung and Cicendo Eye Hospital Bandung.

Results: The study included a total of 28 patients, 11 males and 17 females. The study diagnosed patients with SJS (33%), SJS/TEN overlap (31%), or TEN (36%). The age range of the majority of patients was 25-44 years (32%). The most commonly implicated medication was acetaminophen, accounting for 43% of the cases. The average length of hospitalization for SJS was 8±3.29 days, for SJS/TEN overlap was 15.12±18.42 days, and for TEN was 13±9.01 days. The highest SCORTEN was 4. Among SJS and SJS/TEN overlap patients, cheilitis was the most frequent complication, while hypokalemia was the most common acute complication in TEN patients (17%). Long-term skin sequelae include hypopigmentation in five patients and hyperpigmentation in eleven. The most common long-term eye sequelae, dry eye, affected 3 patients.

Conclusion: Common acute complications include extensive cheilitis, hypoalbuminemia, hypocalcemia, acute conjunctivitis, and acute kidney injury. Hyperpigmentation and hypopigmentation were found as the most frequent long-term skin complications, and dry eyes were the most frequent long-term eye sequelae. Further studies on the physical sequelae of SJS/TEN are necessary to enhance our understanding of the condition and improve treatment for survivors.

Keywords: Stevens-Johnson syndrome; acute complications; long-term sequelae; toxic epidermal necrolysis.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Mean duration of hospitalization.
Figure 2
Figure 2
Mean SCORETEN.
See this image and copyright information in PMC

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