Seasonal variation of Stevens-Johnson syndrome and toxic epidermal necrolysis associated with trimethoprim-sulfamethoxazole - 08/08/11
Reprint requests: Paul A. Klekotka, MD, PhD, Division of Dermatology, Washington University School of Medicine, 660 S Euclid, St Louis, MO 63110.Abstract |
Background |
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and severe cutaneous adverse reactions to medications and infections.
Objective |
We sought to determine whether a seasonal variation to SJS and TEN exists and to define the characteristics in our tertiary referral hospital.
Methods |
A retrospective chart review of 50 patients from 1995 through 2007 was performed and statistically analyzed.
Results |
The most common medication implicated as a cause of SJS/TEN was trimethoprim-sulfamethoxazole (TMX) (26%). A seasonal trend, favoring springtime, was observed for the total number of cases of SJS and TEN (P = .34). There was a significant increase in cases due to TMX (53%) occurring in spring compared to other seasons (P = .002). These patients were significantly younger (37.8 ± 13.7) than other patients with SJS and TEN (53.7 ± 16.4) (P = .003). Their overall mortality (1 death) and average SCORTEN value (1.62 ± 1.6) was also significantly lower (P = .04 and 0.03, respectively). Based on outpatient pharmacy records, there was no increase in TMX prescriptions filled during the spring.
Limitations |
The study was limited by reliance on chart data, the use of inpatient records, and number of patients.
Conclusions |
A seasonal variation in SJS and TEN caused by TMX affecting younger patients may exist.
Le texte complet de cet article est disponible en PDF.Abbreviations used : HSV, IVIg, SCAR, SJS, TEN, TMX
Plan
| Supported in part by a grant from the Dermatology Foundation and grant 1K08AR55156 from the National Institute of Arthritis, Musculoskeletal and Skin Diseases/National Institutes of Health, both awarded to Dr Klekotka. |
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| Conflicts of interest: None declared. Dr Anadkat has received a speaker’s honorarium from ImClone and Genentech. |
Vol 60 - N° 4
P. 589-594 - avril 2009 Retour au numéro
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