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High Reoccurrence Rate of SJS and TEN

Filed June 12th, 2014 Eric

The risk of future episodes of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) is significantly higher than the risk of a first episode, according to a research letter.

The letter was published by Yaron Finkelstein, MD, of the Hospital for Sick Children in Toronto in the June 4 issue of the Journal of the American Medical Association. Finkelstein based his comments on a 10-year population-based cohort study of all Ontario residents hospitalized for a first episode of SJS (567 patients) or TEN (141 patients) between April 2002 and March 2011, HealthDay News reported.

The researchers found that 84 patients died in the hospital and an additional 43 died within 60 days of hospital discharge, equating to short-term mortality rate of 23.4 percent for patients with TEN and 9.0 percent for patients with SJS, HealthDay News reported. The other 581 patients were tracked for a median of 1,283 days. Researchers found that hospitalization for a recurring episode of SJS or TEN occurred in 42 patients (7.2 percent). That represented an incidence rate of 16 recurrent SJS or TEN episodes per 1,000 person-years.

Researchers also revealed that eight patients (1.4 percent) experienced multiple recurrences. The first recurrence happened in a median time of 315 days, according to HealthDay News. Researchers said factors such as rurality and delivery of care at an academic hospital during the initial admission were factors associated with recurrence.

“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,” the authors write.

SJN and TEN are severe forms of skin disease that can cause rash, skin peeling and sores on the mucous membranes. The reactions can be caused by a variety of drugs and have often been associated with non-steroidal anti-inflammatory drugs (NAIDs) and antibiotics.

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