Clinical analysis of 73 patients with Stevens Johnson syndrome or toxic epidermal necrolysis

Objective To analyze the pathogenic factors,clinical characteristics,treatment and outcome of Stevens Johnson syndrome(SJS) and toxic epidermal necrolysis(TEN),so as to provide data for its clinical prevention. Methods The clinical data of 73 patients with SJS or TEN was analyzed,and 34 patients were treated with prednisolone sodium succinate combined immunoglobulin(Group A),and 39 patients were treated with prednisolone sodium succinate combined hematodialysis(Group B).The general data,pathogenic factors,clinical features,laboratory results,treatment and outcomes were all summarized. Results The etiology of 58 patients has been determined,in which 57 patients were induced by drugs(98.3%);the drugs were given priority to allopurinol and carbamazepine,accounted for 34.5% and 24.1%,respectively.The common clinical features were fervescence,electrolyte disturbances,elevated leukocyte,liver enzymes and urea nitrogen,with an occurrence rates over 30%;the incidence of hyperglycemia was 20.5%.The total pathogenic bacteria positive rate was 91.8%,in which the skin pathogenic bacteria positive rate was the highest(83.6%).The bacteria were mainly staphylococcus aureus(61.6%).There was no significant difference in fever subsidence time,hospital stay and death rate between the two groups(P>0.05).The treatment expense of Group A was lower than that of Group B,the difference had statistical significance(P>0.05). Conclusion In the past two years,the mainly drugs that induced SJS and TEN were purine and carbamazepine.On the basis of symptomatic treatment,both glucocorticoid combined immune globulin and glucocorticoid combined hemodialysis can get good curative effect.