Corticosteroids plus Intravenous Immunoglobulin in the Treatment of 7 Cases with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

  Objective  To summarize the clinical features and treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).

  Methods  Seven patients with SJS/TEN were included in the study. The clinical data including severity of illness, eye involvement, causative drugs, treatment, and prognosis were retrospectively analyzed.

  Results  The age of these patients ranged 26 to 81 years. Mucous membranes were affected in all cases. The common agents triggering SJS/TEN in these patients were nonsteroidal anti-inflammatory drugs (NSAIDs), antiepileptic drugs, and allopurinol. All these seven patients were then treated with corticosteroids plus intravenous immunoglobulin (IVIG) for their SJS/TEN. The skin lesions were healed in 6 cases, and 1 death occurred.

  Conclusions  SJS/TEN is a life-threatening exfoliating disease of the skin and mucous membranes, and the mortality can be high without proper treatment. The use of adequate dose of corticosteroids plus IVIG is a main treatment for SJS/TEN, although the prognosis can be poor in patients with systemic diseases. Since ocular involvement in the acute stage may not relate to the severity of SJS/TEN, early ophthalmic assessment and proper treatment is warranted.