Title: A Retrospective Study of Drugs Suspected for SJS/TEN Reactions in a Tertiary Care Center of North India

Authors: Dr Bimal Kanish, Dr Emy A. Thomas, Dr Naiyna Nangia, Dr Shavinder Singh

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.203

Abstract

Steven Johnson syndrome and Toxic epidermal necrolysis are types of severe adverse cutaneous reactions. Though they are rare, they are potentially fatal reactions endangering a patient's life. This retrospective study was done to detect the probable drugs implicated in SJS-TEN is our hospital and their clinical outcome. SJS-TEN is seen to occur among most commonly prescribed drugs. All patients of either sex, with the clinical diagnosis of SJS, SJS-TEN overlap or TEN (according to Bastuji et al criteria), who were admitted in the Dermatology department from April 2010 till August 2017 were included in the study. All relevant data including demographics of patient, symptoms, drug intake, duration of rash, reaction time (time taken for the reaction to appear since the last exposure to the drug), previous history or family history regarding drug allergy, history of complications arising, details of clinical examination at the time of presentation, along with significant systemic findings and clinical outcome were noted in a proforma. Baseline investigations, if done at the time of presentation, were noted down in the proforma. Drug(s) that had been taken within four weeks preceding the onset of symptoms were considered as ‘’culprit drugs’’. If the patient had taken more than one drug, all of them were considered culprit drugs. Nonsteroidal anti-inflammatory drugs (NSAIDs) (33.9%) was the most common causative drug group followed by antimicrobials (32.03%), xanthine oxidase inhibitors (13.6%) and antiepileptic drugs (5.83%) in this study. Early identification of the causative drug will help in prompt withdrawal of the drug thus reducing the morbidity and mortality among patients with SJS-TEN. This study aims to create awareness among the treating physicians about the drugs implicated in life threatening reactions to facilitate the judicious use of these drugs in future.

Key words: SJS, TEN, SJS-TEN overlap, drugs.

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Corresponding Author

Dr Emy A. Thomas

Telephone number: 7087282878, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.