PMID- 30825193
STAT- Publisher
LR  - 20190302
IS  - 1365-4632 (Electronic)
IS  - 0011-9059 (Linking)
DP  - 2019 Mar 1
TI  - Stevens-Johnson syndrome and toxic epidermal necrolysis: retrospective review of 
      10-year experience.
LID - 10.1111/ijd.14409 [doi]
AB  - BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)
      are severe mucocutaneous disorders. To date, relatively few studies have looked
      at institutional approaches to treatment of SJS/TEN, particularly with a focus on
      wound care. METHODS: A retrospective review was conducted on patients admitted to
      the Hennepin County Medical Center from 2007 to 2017 with a final diagnosis of
      SJS or TEN. Data were obtained for demographics, causative drug, hospital course,
      supportive care, medical management, complications, and disposition. RESULTS: A
      total of 48 were diagnosed with SJS/TEN during the study period. A total of 41.7%
      (20/48) were men, and the mean age was 49.2 years. Sulfa antibiotics and nonsulfa
      antibiotics were the most common causative drug categories, each accounting for a
      quarter of cases. Supportive measures included intravenous fluid resuscitation in
      4.2% of cases, enteral nutrition in 75%, surgical debridement in 27.1%, and
      porcine xenograft in 16.7%. Wound care consisted of use of a cleanser in 95.8% of
      patients, topical antibiotic in 95.8%, topical steroid in 20.8%, topical
      antifungal in 14.6%, emollient in 83.3%, nonadherent dressing in 97.9%, silver
      impregnated dressing in 39.6%, nonsilver impregnated dressing in 79.2%, and
      general wrap in 93.8%. For medical treatment, 64.6% of patients received
      intravenous immunoglobulin (IVIG), and 8.3% of patients received cyclosporine.
      Mortality rate was 12.5% overall, compared to an expected mortality rate of 25.2%
      as predicted by SCORTEN. CONCLUSIONS: Patients treated with our current regimen
      of care showed a mortality rate half of that predicted by SCORTEN.
CI  - (c) 2019 The International Society of Dermatology.
FAU - Zhang, Amy J
AU  - Zhang AJ
AD  - University of Minnesota Medical School, Minneapolis, MN, USA.
FAU - Nygaard, Rachel M
AU  - Nygaard RM
AD  - Department of Surgery, Hennepin County Medical Center, Minneapolis, MN, USA.
FAU - Endorf, Frederick W
AU  - Endorf FW
AD  - Department of Surgery, Hennepin County Medical Center, Minneapolis, MN, USA.
FAU - Hylwa, Sara A
AU  - Hylwa SA
AD  - Department of Dermatology, University of Minnesota, Minneapolis, MN, USA.
AD  - Department of Dermatology, Hennepin County Medical Center, Minneapolis, MN, USA.
LA  - eng
PT  - Journal Article
DEP - 20190301
PL  - England
TA  - Int J Dermatol
JT  - International journal of dermatology
JID - 0243704
EDAT- 2019/03/03 06:00
MHDA- 2019/03/03 06:00
CRDT- 2019/03/03 06:00
PHST- 2018/05/08 00:00 [received]
PHST- 2018/11/25 00:00 [revised]
PHST- 2019/01/29 00:00 [accepted]
PHST- 2019/03/03 06:00 [entrez]
PHST- 2019/03/03 06:00 [pubmed]
PHST- 2019/03/03 06:00 [medline]
AID - 10.1111/ijd.14409 [doi]
PST - aheadofprint
SO  - Int J Dermatol. 2019 Mar 1. doi: 10.1111/ijd.14409.