• Diana Monteiro, Paula Egipto, Julia Barbosa, Ricardo Horta, Jose Amarante, Pedro Silva, and Alvaro Silva.
• a Centro Hospitalar de Sao Joao , Porto , Portugal.
• Cutan Ocul Toxicol. 2017 Jun 1; 36 (2): 163-168.

ContextStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) corresponds to a rare and acute life-threatening mucocutaneous reactions characterized by extensive necrosis and epidermal detachment. There are no efficacious pharmaceutical interventions proven through large clinical trials.ObjectiveWe sought to study clinical cases admitted in our institution in order to determine which drugs and medical comorbidities or treatments impacted the mortality.Material And MethodsIn a retrospective study over 9 years we evaluated all patients presenting biopsy-proven SJS or TEN for age, gender, total body surface area involved, causing agents, SCORTEN score, blood transfusion, steroid administration, intubation, length of intensive care stay and death rate. Statistical analysis was done using SPSS statistical software.ResultsThe highest incidence of SJS and TEN was in age group of 71-80 years. Of the 30 patients, 30% died from SJS/TEN, mainly due sepsis. For each subgroup SJS/TEN overlap had the highest mortality. The highest mortality was from antibiotic treatment as causing agent. Step-wise regression analysis identified mechanical ventilation requirement and age over 65 years as mortality high-risk factors.DiscussionThe most crucial interventions are discontinuation of the offending drug and prompt referral to a burn unit, which helps in early diagnosis and decrease mortality in these diseases.ConclusionWhen SJS/TEN is caused by antibiotics suspicion of developing fatal sepsis should be high, independently of patients' medical condition.

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