Objectives: Stevens Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and their overlap (SJS/TEN) are severe acute mucocutaneous diseases, triggered manly by a newly administered drug, life threatening and rare, which still lack a definite treatment method. Our aim was to describe the clinical aspects and etiologic factors of SJS, SJS/TEN and TEN in order to evaluate treatment responses and different outcomes in mortality regarding the therapeutic options.

Materials and Methods: This is a retrospective study of patients with the diagnosis described above, who were admitted to our center between 2000 and 2016 in order to characterize their clinical evaluation, treatment and mortality. Detached BSA% was used to categorize the disorder. Logistic regression was used to identify predictive variables of mortality.

Results: The final diagnosis was 16 patients with SJS, 35 patients with TEN and 06 patients with SJS/TEN, with ages comprised between 15 and 91 years old, mainly females. The majority of patients with SJS were treated in the Dermatology Department and the majority of patients with TEN were treated in our Burn Center Unit. The most commonly reported causative agent was allopurinol. Oral erosion was the most reported mucosal erosion and ocular involvement was reported in 47% of patients.

There was no statistical difference in mortality between patients treated with corticosteroids or intravenous immunoglobulin and plasmapheresis.

Conclusions
Although the majority of patients with SJS can be treated outside an intensive care unit like our Burn Center Unit, TEN remains a challenging life-threatening disease and many questions regarding best treatment strategies are still without an answer. In the mean time we can state that the discontinuation of the suspected drug, wound care and early supportive therapies contribute to lowering the mortality rates.

Stevens Johnson syndrome and toxic epidermal necrolysis: a single center review.