Steven-Johnson Syndrome and toxic epidermal necrolysis at a tertiary care centre in South India: a 12 year retrospective analysis

Vidya Kuntoji, Chandramohan Kudligi, Pradeep Vittal Bhagwat, Ravi Munasingh Rathod, Suman Gurunathgouda Odugoudar, Mahesh Kurugodiyavar, Ranjan Jeevannavar, Dr. Arika


Background Stevens-Johnson syndrome and Toxic epidermal necrolysis are life threatening mucocutaneous reactions with high mortality. Drugs are the major implicated etiologic agents; others include infections, immunisation, malignancies, radiotherapy and idiopathic. The knowledge on the drugs causing SJS/TEN in a given population can be ascertained by knowing the type of prescription and associated conditions of the patients.


Aims 1-To study the demography, etiologic agents, associated conditions and mortality in patients with SJS/TEN. 2- To study the impact of HIV on SJS/TEN with respect to mortality.


Materials and Methods A retrospective study was performed by analysing the medical records of patients with SJS, TEN, SJS/TEN overlap admitted in a tertiary care hospital over a period of 12 years.


Results Out of 86 patients enrolled in the study, TEN constituted 69(80.23%), SJS 13(15.11%) and SJS/TEN overlap 4 (4.65%). Male to female ratio was 0.72. Maximum number of patients were in 4th decade (25.58%). Antimicrobials (50.00%), antiepileptics (22.91%) and NSAIDs (16.66%) were responsible in majority of patients. HIV (39.53%) and epilepsy (20.93%) were the most common associated conditions. Mortality was seen in 9 patients (10.0%) amongst which 4 patients had HIV infection. There was no statistically significant difference between mortality seen in HIV infected patients and those who did not have HIV (p-value=0.75).


Conclusion Drugs constituted major causative agents. HIV infection had no significant impact on SJS/TEN with respect to mortality. However further studies are needed to substantiate this finding.



Steven-Johnson syndrome, toxic epidermal necrolysis, HIV, drugs

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