STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS – A 10-YEAR STUDY

Detalhes bibliográficos
Autor(a) principal: Brinca, Ana
Data de Publicação: 2011
Outros Autores: Andrade, Pedro, Xavier, Maria Manuel, Gonçalo, Margarida, Figueiredo, Américo
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.29021/spdv.69.3.76
Resumo: Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are uncommon mucocutaneous der- matosis with a potentially fatal outcome, mostly secondary to drug administration. The aim of this retrospective study was to evaluate the clinical and evolutive characteristics of the patients with SJS and TEN admitted to the Dermatology Department of Coimbra University Hospital, between June/2000 and June/2010. 38 patients (27 women and 11 men) were included, with a mean age of 58.5 years (±21,63 years, 14-88 years), 26 with SSJ, 4 with SJS-TEN overlap and 8 with TEN. Involve- ment of oral, ocular and genitalia mucous membranes were present in 35, 30 and 13 patients respectively, with involvement of at least two in 31 patients. Drugs were the causative factors in 81.6% of patients: allopurinol in 36%, antibiotics in 23%, anticonvulsants in 19% and nonsteroidal anti-inflammatory drugs in 10%. The mortality rate was 8.3% for SJS and 37.5% for TEN. There was a significant correlation between the fatal outcome and a state of immunosuppression, presence of me- tabolic acidosis and involvement of the genital mucosa. The reasonable and rational use of drugs is of crucial importance, particularly allopurinol, the most likely causative factor, in 29% of total, and present in 40% of patients with a fatal outcome.KEYWORDS – Stevens-Johnson Syndrome; Epidermal Necrolysis, Toxic; Allopurinol; Drug Eruptions; Pharmaceutical Preparations/Adverse Effects.
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spelling STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS – A 10-YEAR STUDYSÍNDROME DE STEVENS-JOHNSON E NECRÓLISE EPIDéRMICA TÓXICA – CASUÍSTICA DE 10 ANOSStevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are uncommon mucocutaneous der- matosis with a potentially fatal outcome, mostly secondary to drug administration. The aim of this retrospective study was to evaluate the clinical and evolutive characteristics of the patients with SJS and TEN admitted to the Dermatology Department of Coimbra University Hospital, between June/2000 and June/2010. 38 patients (27 women and 11 men) were included, with a mean age of 58.5 years (±21,63 years, 14-88 years), 26 with SSJ, 4 with SJS-TEN overlap and 8 with TEN. Involve- ment of oral, ocular and genitalia mucous membranes were present in 35, 30 and 13 patients respectively, with involvement of at least two in 31 patients. Drugs were the causative factors in 81.6% of patients: allopurinol in 36%, antibiotics in 23%, anticonvulsants in 19% and nonsteroidal anti-inflammatory drugs in 10%. The mortality rate was 8.3% for SJS and 37.5% for TEN. There was a significant correlation between the fatal outcome and a state of immunosuppression, presence of me- tabolic acidosis and involvement of the genital mucosa. The reasonable and rational use of drugs is of crucial importance, particularly allopurinol, the most likely causative factor, in 29% of total, and present in 40% of patients with a fatal outcome.KEYWORDS – Stevens-Johnson Syndrome; Epidermal Necrolysis, Toxic; Allopurinol; Drug Eruptions; Pharmaceutical Preparations/Adverse Effects.A síndrome de Stevens-Johnson (SSJ) e a Necrólise Epidérmica Tóxica (NET) são dermatoses mucocutâneas pouco frequentes, potencialmente fatais, na grande maioria secundárias à administração de fármacos. O objectivo deste estudo retrospectivo foi a caracterização clínico-evolutiva dos doentes com SSJ e NET hospitalizados no Serviço de Dermatologia dos Hospitais da Universidade de Coimbra, entre Junho de 2000 a Junho de 2010. Incluíram-se 38 doentes (27 mulheres e 11 homens), com idade média de 58,5 anos (±21,63 anos, intervalo: 14-88 anos); 26 com SSJ, 4 com síndrome de sobreposição SSJ-NET e 8 com NET. O envolvimento das mucosas oral, ocular e genital ocorreu em 35, 30 e 13 doentes, respectivamente, envolvendo mais que uma mucosa em 31 doentes. Foi identificado um fármaco como provável desencadeante em 81,6% dos casos: alopurinol em 36%, antibiótico em 23%, anticonvulsivante em 19% e anti-inflamatório não esteróide em 10%. A taxa de mortalidade foi de 8.3% para o SSJ e de 37.5% para a NET. Constatou-se uma associação positiva entre desfecho fatal e condição imunossupressora, presença de acidose metabólica e envolvimento da mucosa genital. O uso ponderado e racional de fármacos é de crucial importância, e em particular do alopurinol, o desencadeante provável mais frequente, em 29% do total de casos, e presente em 40% dos casos com prognóstico fatal.PALAVRAS-CHAVE – Síndrome de Stevens-Johnson; Necrólise Epidérmica Tóxica; Alopurinol; Reacções Cutâneas Adversas a Fármacos.Sociedade Portuguesa de Dermatologia e Venereologia2011-09-28T00:00:00Zjournal articleinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.29021/spdv.69.3.76oai:ojs.revista.spdv.com.pt:article/76Journal of the Portuguese Society of Dermatology and Venereology; Vol 69 No 3 (2011): Julho - Setembro; 403Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 69 n. 3 (2011): Julho - Setembro; 4032182-24092182-2395reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spdv.com.pt/index.php/spdv/article/view/76https://doi.org/10.29021/spdv.69.3.76https://revista.spdv.com.pt/index.php/spdv/article/view/76/74Brinca, AnaAndrade, PedroXavier, Maria ManuelGonçalo, MargaridaFigueiredo, Américoinfo:eu-repo/semantics/openAccess2022-10-06T12:34:39Zoai:ojs.revista.spdv.com.pt:article/76Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:10:40.349137Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS – A 10-YEAR STUDY
SÍNDROME DE STEVENS-JOHNSON E NECRÓLISE EPIDéRMICA TÓXICA – CASUÍSTICA DE 10 ANOS
title STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS – A 10-YEAR STUDY
spellingShingle STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS – A 10-YEAR STUDY
Brinca, Ana
title_short STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS – A 10-YEAR STUDY
title_full STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS – A 10-YEAR STUDY
title_fullStr STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS – A 10-YEAR STUDY
title_full_unstemmed STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS – A 10-YEAR STUDY
title_sort STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSIS – A 10-YEAR STUDY
author Brinca, Ana
author_facet Brinca, Ana
Andrade, Pedro
Xavier, Maria Manuel
Gonçalo, Margarida
Figueiredo, Américo
author_role author
author2 Andrade, Pedro
Xavier, Maria Manuel
Gonçalo, Margarida
Figueiredo, Américo
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Brinca, Ana
Andrade, Pedro
Xavier, Maria Manuel
Gonçalo, Margarida
Figueiredo, Américo
description Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are uncommon mucocutaneous der- matosis with a potentially fatal outcome, mostly secondary to drug administration. The aim of this retrospective study was to evaluate the clinical and evolutive characteristics of the patients with SJS and TEN admitted to the Dermatology Department of Coimbra University Hospital, between June/2000 and June/2010. 38 patients (27 women and 11 men) were included, with a mean age of 58.5 years (±21,63 years, 14-88 years), 26 with SSJ, 4 with SJS-TEN overlap and 8 with TEN. Involve- ment of oral, ocular and genitalia mucous membranes were present in 35, 30 and 13 patients respectively, with involvement of at least two in 31 patients. Drugs were the causative factors in 81.6% of patients: allopurinol in 36%, antibiotics in 23%, anticonvulsants in 19% and nonsteroidal anti-inflammatory drugs in 10%. The mortality rate was 8.3% for SJS and 37.5% for TEN. There was a significant correlation between the fatal outcome and a state of immunosuppression, presence of me- tabolic acidosis and involvement of the genital mucosa. The reasonable and rational use of drugs is of crucial importance, particularly allopurinol, the most likely causative factor, in 29% of total, and present in 40% of patients with a fatal outcome.KEYWORDS – Stevens-Johnson Syndrome; Epidermal Necrolysis, Toxic; Allopurinol; Drug Eruptions; Pharmaceutical Preparations/Adverse Effects.
publishDate 2011
dc.date.none.fl_str_mv 2011-09-28T00:00:00Z
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url https://doi.org/10.29021/spdv.69.3.76
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dc.relation.none.fl_str_mv https://revista.spdv.com.pt/index.php/spdv/article/view/76
https://doi.org/10.29021/spdv.69.3.76
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dc.publisher.none.fl_str_mv Sociedade Portuguesa de Dermatologia e Venereologia
publisher.none.fl_str_mv Sociedade Portuguesa de Dermatologia e Venereologia
dc.source.none.fl_str_mv Journal of the Portuguese Society of Dermatology and Venereology; Vol 69 No 3 (2011): Julho - Setembro; 403
Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 69 n. 3 (2011): Julho - Setembro; 403
2182-2409
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