[Clinical Characterization of Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis at a Tertiary...

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse drug reactions.

This study aimed to describe the clinical, laboratory, and treatment received in patients with SJS/TEN treated at a high-complexity Chilean hospital, and to analyze their possible association with morbidity and mortality outcomes.

Cross-sectional, observational, and analytical study. Data were collected through a review of the clinical records of patients with SJS/TEN treated at the Clinical Hospital of the Pontifical Catholic University of Chile between 2014 and 2021.

A total of 30 patients, adults and children, were included, with 80% being female. The most implicated drugs were anticonvulsants (50%) and antibiotics (13.3%). 92% of the patients were managed in critical care units, and 70% received combination pharmacological therapy. Only one patient was treated with anti-TNF alpha. 60% had concomitant infections, and 13.3% developed sepsis. Two patients died from causes unrelated to the drug reaction. The use of cyclosporine was associated with a higher risk of infection (90.9%; p = 0.018). Eosinophils and CRP were the best predictors of hospital stay duration (Spearman's r: -0.5745 and 0.5325; p=0.0011 and 0.0029, respectively).

SJS/TEN is associated with high morbidity and mortality, including infections and sepsis, with management focused on discontinuing the causative drug and providing intensive supportive care. In our cohort, there were no significant differences in outcomes based on the treatment received, except for a higher probability of infections with the use of cyclosporine. Our findings provide valuable insight into the clinical characteristics of SJS/TEN in a Latin American country.