Chulalongkorn Medical Journal


Introduction : Stevens-Johnson syndrome (SJS), Toxic Epidermal Necrolysis (TEN)and drug hypersensitivity syndrome (HSS) are severe cutaneousadverse reactions (SCAR) that is mostly related to drugs. Althoughincidence is rare, it has significant impact on patient’s well beingbecause of its high mortality rates.Objective : To investigate the causative drugs, prevalence and mortality ratesrelated to SCAR, which were from drug exposure during 2003 - 2007.Setting : Siriraj Hospital, Bangkok.Research design : A retrospective studyPatients : Patients who were diagnosed to be SJS, TEN and HSS were included.Method : Five years retrospective data, 2003 - 2007, was collected fromelectronic database of Adverse Drug Reaction Monitoring Center andSiriraj Computer Center.Result : SCAR was found in 136 patients during 2003-2007 including 84 caseswith SJS (61.76%), 3 cases with SJS overlap TEN (2.21%), 10 caseswith TEN (7.35%) and 39 cases with HSS (28.68%). The prevalence ofSJS, TEN and HSS were most often found in patients treated withcarbamazepine, allopurinol and phenytoin, respectively. Mortality rateof SJS, TEN and HSS were 6.90%, 50.0% and 12.82% respectively.Conclusion : Top three main drug groups causing SCAR were, namely: anticonvulsants(34.56%), antimicrobial (25.74%) and antigout (14.70%).Allopurinol revealed the highest mortality rate.


Faculty of Medicine, Chulalongkorn University



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