Individuals who are hospitalized for the skin conditions of Stevens-Johnson syndrome and toxic epidermal necrolysis appear to have a high risk of recurrence, according to a new study.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening conditions that develop primarily as responses to drugs, and result in extensive epidermal detachment (upper layers of the skin detach from the lower layers). Recurrence has been reported in isolated cases, and the overall risk of recurrence has been unknown, according to background information in the article.
Yaron Finkelstein, M.D., of the Hospital for Sick Children, Toronto, and colleagues conducted a study that included data of all Ontario residents hospitalized for a first episode of Stevens-Johnson syndrome or toxic epidermal necrolysis between April 2002 and March 2011. Patients were followed up from admission until March 31, 2012, or death. The researchers identified 708 individuals hospitalized for a first episode of SJS (n = 567) or TEN (n = 141), including 127 (17.9 percent) children younger than 18 years.
Forty-two patients (7.2 percent) were hospitalized for a subsequent episode of Stevens-Johnson syndrome or toxic epidermal necrolysis. Eight patients (1.4 percent) experienced multiple recurrences. The median time to first recurrence was 315 days.
“In light of the reported incidence of SJS and TEN in the general population (1.0-7.2 cases/1 million individuals/year), the observed recurrence risk in our study (>7 percent) is several thousand-fold higher than would be expected if subsequent episodes were probabilistically independent of the first SJS or TEN episode. We speculate that this increased risk reflects individual susceptibility. Genetic predisposition has been identified for several medications in association with specific genotypes …” the authors write.
“… these findings are relevant to physicians who care for patients with a history of SJS or TEN. Because most such episodes are drug-induced, the high risk of recurrence should be recognized, and the benefits of drug therapy weighed carefully against the potential risks. This is particularly true for drugs commonly associated with the development of these frequently fatal conditions.”
Citation: Yaron Finkelstein MD, ABCP(Dip), Erin M. Macdonald MSc, Ping Li PhD, Janine R. Hutson MD, MSc, David N. Juurlink MD, PhD, 'Recurrence and Mortality Following Severe Cutaneous Adverse Reactions', JAMA. 2014;311(21):2231-2232. doi:10.1001/jama.2014.839
- PHYSICAL SCIENCES
- EARTH SCIENCES
- LIFE SCIENCES
- SOCIAL SCIENCES
Subscribe to the newsletter
Stay in touch with the scientific world!
Know Science And Want To Write?
- What Do EU Countries Give Up When They Opt-out Of GMO Crops? And For Whom?
- An Easy Problem
- Nobel Prize Validates Chinese Medicine? Nope.
- Thank You Guido
- September 24th, 2015 - Just Another Day In Space - Asteroid Flybys, "Blood Moons" And Armageddon Demystified
- Prenatal BPA Exposures (Don’t) Affect Birth Weight
- Machine learning vs NRA, a Grand Challenge
- "This is a bit of irony: Mother Jones, which can never be bothered with facts or truth and got sued..."
- "Great piece Steve. While the potential for suffering and death in Africa especially thanks to this..."
- "I look forward to more threats and libel from you in the very near future. It's your stock in trade..."
- "Dear Mr. Campbell: Again you spin and dissemble. It was quite clear from the many tweets between..."
- "One of us does not know what libel means (hint: It is you). Calling me a felon and a fraud is libel..."
- FDA-Approved Test for Meningitis is a Home Run
- Trends In Smoking – Chinese Men In Peril, American Women Get Better Cessation
- Counter-Point: Activists Operate By Outrage, Not Fear
- Whole Foods Recalls Organic Roquefort Cheeses After Listeria Found
- Suicide Tries Linked to Weight-Loss Surgery? Study Doesn’t Show
- Following Rules, Refreezing Thawed Meat is Safe
- Beetles provide clues about the genetic foundations of parenthood
- Trees to power: McMaster engineers build better energy storage device
- High dose chemo & stem cell transplantation results in long-term survival for amyloid patients
- 'Blind analysis' could reduce bias in social sciences papers
- Adoption of streamlined breast cancer treatment has stagnated, study finds