Original articleDiagnosis and Treatment of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis with Ocular Complications
Section snippets
Patients and Methods
From November 2005 through May 2008, extensive interviews were conducted with 94 patients (45 males and 49 females) with SJS or TEN with ocular complications seen at the SJS outpatient service at Kyoto Prefectural University Hospital. Of those patients, 88 cases were referral patients from the greater Japan area who had come to the SJS service at the acute stage (n = 14) or at the chronic stage (n = 74). Their ages ranged from 1 to 83 years (mean age±standard deviation, 41.6±18.5 years). At
Results
Of the 94 patients, drugs were the most commonly associated etiologic factor in 84 patients (89.4%). The causative drugs were cold remedies in 30 patients, antibiotics in 23 patients, nonsteroidal anti-inflammatory drugs in 19 patients, anticonvulsants in 5 patients, and others (anticancer agents, antirheumatic drugs, antimalarial, Chinese medicine, etc.).
Best-corrected visual acuity obtained at the chronic stage was 20/20 or better in 34 eyes (18.3%; Fig 1A), worse than 20/20 and up to and
Discussion
Stevens-Johnson syndrome and TEN are rare but potentially fatal skin disorders. Ocular involvement is common and often results in long-term complications such as serious visual impairment with ocular discomforts.13, 28 Although much has been learned over the past 50 years about the management of SJS and TEN, the following 3 important problems still remain: (1) the difficulty of obtaining a prompt and accurate diagnosis of SJS or TEN at disease onset, (2) ocular involvement often is overlooked
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Manuscript no. 2008-1063.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Supported in part by Health and Labor Sciences Research Grants (Research on Intractable Diseases) from the Ministry of Health, Labour and Welfare of Japan, Tokyo, Japan; the Japanese Ministry of Education, Culture, Sports, Science and Technology, Tokyo, Japan; the Kyoto Foundation for the Promotion of Medical Science, Kyoto, Japan; and the Intramural Research Fund of Kyoto Prefectural University of Medicine, Kyoto, Japan.