Distinguishing Stevens-Johnson syndrome/toxic epidermal necrolysis from clinical mimickers during inpatient dermatologic consultation—A retrospective chart review - 15/08/19
Abstract |
Background |
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening conditions that may present with similar findings to other severe dermatologic diseases.
Objective |
The primary objective of this exploratory study was to explore factors associated with SJS/TEN and develop a model that provides the predicted probability of SJS/TEN for patients for whom the diagnosis of SJS/TEN is considered.
Methods |
Retrospective review of consultations for patients with suspected SJS, TEN, or overlap at 4 academic dermatology consultation services.
Results |
Overall, 208 patients were included; 59 (28.4%) had a final diagnosis of SJS/TEN, and 149 (71.6%) were given a different diagnosis. The most common mimickers were drug hypersensitivity syndrome (n = 21, 10.1%), morbilliform drug eruption (n = 18, 8.7%), erythema multiforme (n = 15, 7.2%), and acute generalized exanthematous pustulosis (n = 13, 6.2%). Nikolsky sign, atypical targets, fever, and lymphopenia were included in a model for predicting the probability of SJS/TEN.
Limitations |
All cases were obtained from academic centers, which may limit the generalization of findings to community-based settings. This was an exploratory study with a small number of cases, and external validation of the model performance is needed.
Conclusion |
Early dermatologic evaluation of patients with suspected SJS/TEN is key to separating patients with this condition from those who ultimately receive diagnoses of other serious skin diseases.
Le texte complet de cet article est disponible en PDF.Key words : dermatology consultation, inpatient, severe cutaneous adverse reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis
Abbreviations used : AGEP, AUC, CI, DRESS, EM, OR, SJS, TEN
Plan
| Additional data are available as supplemental material at kzm64tt5k7.1. |
|
| Funding sources: None. |
|
| Conflicts of interest: None disclosed. |
|
| Reprints not available from the authors. |
Vol 81 - N° 3
P. 749-757 - septembre 2019 Retour au numéro
Article précédent
- Dermatology-specific and all-cause 30-day and calendar-year readmissions and costs for dermatologic diseases from 2010 to 2014
- Myron Zhang, Alina Markova, Joanna Harp, Stephen Dusza, Misha Rosenbach, Benjamin H. Kaffenberger
- Cost analysis of a store-and-forward teledermatology consult system in Philadelphia
- Xiaoshi Yang, John S. Barbieri, Carrie L. Kovarik
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?