Steven-Johnson syndrome and toxic epidermal necrolysis in Northern Sarawak between year 2011 and 2015: A retrospective review of causative agents and clinical outcome

Kee Tat Lee, Teh Yeon Chiat, Yong Kar Ying, Pubalan A/L Muniandy


Objective To determine the causes and treatment outcome of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).


Methods A retrospective review was conducted on SJS and TEN cases admitted to Miri General Hospital between year 2011 and 2015.


Results Total of ten patients were admitted in five years period, nine cases of SJS and one case of TEN with highest number recorded in 2014 (4 cases). The commonest causative agent was allopurinol (30%).  Among the ten cases, 7 patients were given steroids, 1 patient given intravenous immunoglobulin (IVIG), 2 patients given both steroids and IVIG. There was a case mortality from SJS secondary to allopurinol after 38 days of admission and patient was given only corticosteroids.


Conclusion Allopurinol is the most common causative agent with mortality in Miri General Hospital. Allopurinol should be used judiciously. Combination therapy had tendency to reduce mortality rate in comparison with corticosteroid therapy alone. However, in view of small sample size, efficacy and superiority between treatment of corticosteroids and IVIG cannot be assessed.



Steven-Johnson syndrome; toxic epidermal necrolysis; drug reaction; steroids; intravenous immunoglobulin

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