Psychological Complications of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review and...

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, severe mucocutaneous diseases associated with high rates of mortality. While the acute complications of SJS and TEN are well documented, it is being increasingly recognised that survivors may develop psychological sequelae that can be associated with significant morbidity. This systematic review and meta-analysis aimed to critically evaluate observational studies of psychiatric complications and quality of life in adults with SJS and TEN. This review was registered with INPLASY and conducted in accordance with the PRISMA reporting guidelines. Potential bias was assessed using the NIH criteria. Ten articles describing results from 1123 cases and 2687 controls were included. The overall quality of the studies was suboptimal, and the level of heterogeneity was very high (I² = 96%). Meta-analysis of eight studies with fifteen study groups (n = 2120) showed a prevalence of psychiatric complications of 24.9% in SJS and TEN patients. SJS and TEN survivors appear to suffer a high burden of psychological complications, including post-traumatic stress disorder, depression, anxiety, as well as quality of life impairment. This population would likely benefit from early multidisciplinary input and long-term follow-up; however, additional larger controlled studies are needed.