Comparison of the acute ocular manifestations of Stevens-Johnson syndrome and toxic epidermal necrolysis in Chinese eyes: a 15-year retrospective study

BMC Ophthalmol. 2017 May 12;17(1):65. doi: 10.1186/s12886-017-0464-9.

Abstract

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening conditions that initially affect the skin and mucous membranes. The aim of this study was to compare the acute ocular manifestations between SJS and TEN.

Methods: The initial presenting ophthalmic records of patients with either SJS (<30% body surface area involvement) or TEN (> = 30% involvement), who were treated at one tertiary burn center in Hong Kong between 1999 and 2014, were retrospectively analyzed and compared.

Results: A total of 20 SJS and 12 TEN cases were included. All were drug-induced. The patient demographics and treatment received were comparable. Overall, 40% of SJS and 75% of TEN patients had acute ocular surface inflammation. When comparing the two groups, there was a significant difference in the number of cases with mild involvement (5% in SJS, 42% in TEN, p = 0.01), while no statistically significant differences were found (p > 0.05) comparing between the moderate (15% in SJS, 0% in TEN) and severe groups (20% in SJS, 33% in TEN).

Conclusions: Ocular surface inflammation was common during the acute phase in both SJS and TEN. TEN had a significantly higher number of cases with mild ocular involvement when compared with SJS, but no significant difference between the number of moderate and severe cases between the two groups.

Keywords: Asians; Ocular surface disease; Severe cutaneous adverse reactions; Stevens-Johnson syndrome; Toxic epidermal necrolysis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Eye Diseases / diagnosis
  • Eye Diseases / epidemiology
  • Eye Diseases / etiology*
  • Female
  • Follow-Up Studies
  • Forecasting*
  • Hong Kong / epidemiology
  • Humans
  • Incidence
  • Male
  • Prevalence
  • Retrospective Studies
  • Severity of Illness Index
  • Stevens-Johnson Syndrome / complications*
  • Stevens-Johnson Syndrome / epidemiology