Differences between Stevens-Johnson syndrome versus toxic epidermal necrolysis.

Area of Science:

• Dermatology
• Toxicology
• Clinical Medicine

Background:

• Reviews outcomes of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
• Questions the practice of averaging mortality rates for SJS and TEN.
• Highlights the rarity of these cutaneous diseases.

Purpose of the Study:

• To compare the outcomes and mortality rates of SJS and TEN.
• To determine if SJS and TEN should be considered a single disease entity for statistical analysis.
• To analyze patient demographics and potential triggers for SJS and TEN.

Main Methods:

• Retrospective chart review of patients diagnosed with SJS and TEN between 2000 and 2020.
• Inclusion of 71 patients: 21 pediatric and 50 adults.
• Dermatopathologist evaluation of pathology slides from 32 adult patients.

Main Results:

• SJS was more common than TEN (3:1 ratio) in both adult and pediatric cases.
• Adult SJS mortality rate was 6.5%, while adult TEN mortality rate was 35.3%.
• Pediatric cases were exclusively SJS, primarily linked to Mycoplasma.
• Chemotherapy-induced TEN showed a 50% mortality rate.

Conclusions:

• SJS and TEN are distinct diseases with significantly different prognoses and outcomes.
• SJS is primarily a mucocutaneous disorder with a good prognosis.
• TEN is a severe systemic toxicity affecting multiple organs with deep skin detachment.
• Averaging mortality rates for SJS and TEN is not clinically advisable.