BACKGROUND: Stevens Johnson syndrome (SJS), Stevens Johnson Syndrome-Toxic Epidermal Necrolysis (SJS-TEN) and Toxic Epidermal Necrolysis (TEN) are dermatologic emergency that necessitate early recognition and management to prevent fatal outcome.
OBJECTIVES: To identify the demographic, etiologic and clinical features, management, outcomes and complications commonly seen in patients diagnosed with SJS-TEN and admitted at the Philippine General Hospital.
METHODS: Available records of all patients with the diagnosis of SJS, SJS-TEN and TEN admitted to the Philippine General Hospital from January 2004 to December 2010 were reviewed.
RESULTS: A total of 31 cases of SJS/TEN were seen. This accounted for 0.01% of the total admissions. Mean age was 45 years with 1: 1.07 female-to-male ratio. Etiologic drugs were mostly anticonvulsants (38.7%), allopurinol (19.4%) and antibiotics (16.20%). The mean time interval between drug intake and onset of symptoms was 15.36 days. Antibiotics had the shortest mean interval (7 days), while phenytoin had the longest (26.8 days). Systemic steroids were given as treatment intervention in majority of cases (98.9%). Average hospital stay was 10 days. Secondary infection was the most common complication seen (41.90%). Resolution was observed in 93.5% of the cases. High SCORTEN score (SCORTEN = 4) corresponded with increased mortality (6.45%).
CONCLUSION: SJS, SJS-TEN and TEN are rare and potentially fatal conditions commonly affecting the middle age group as seen in this study. Anticonvulsant was the most common group of drug implicated in our review. These findings were similar with studies done in other Asian countries. Systemic corticosteroid was the mainstay of treatment at our institution due to its low cost, availability and efficacy when given early on in the disease.

Human ; Male ; Female ; Adrenal Cortex Hormones ; Allopurinol ; Anti-bacterial Agents ; Anticonvulsants ; Coinfection ; Demography ; Fatal Outcome ; Hospitalization ; Hospitals, General

This is a case of a 20-year-old female with no known comorbidities presenting with verrucous plaques arranged in a unilateral blaschkoid distribution at birth. Biopsy was consistent with epidermal nevus hence patient was diagnosed as systematized epidermal nevus, Nevus Unius Lateris type. Gold standard treatment is full thickness surgical excision however, due to the extensive involvement, treatment of this condition remains a challenge. Hence, non-surgical combination of ablative CO2 laser and topical tretinoin 0.1% were done. Thinner lesions (1-3 mm) showed lower recurrence (50%) as compared to thicker lesions (>3 mm) showing 100% recurrence after six months. Hence, another CO2 laser session is needed. Quality of life was measured using the Dermatologic Life Quality Index (DLQI) with noted 35% improvement post-treatment.
CO2 laser ; lasers, gas ; tretinoin ; retinoids