Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A 15-year Regional Burn Center Experience

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) constitute rare and potentially life-threatening dermal hypersensitivity reactions marked by epidermal necrosis and skin blistering. They present a substantial health care burden and challenge to burn units. To advance our understanding of TEN/SJS and the patient cohort at risk for mortality, we hereby report our long-term experience in the management of patients with TEN/SJS. For this purpose, intensive care patients with TEN/SJS admitted between 2007 and 2022 to a single major burn unit in Germany were assessed. Clinical, demographic, and mortality data were collected and examined. A total of 92 patients were included. Mortality was 46.7%, with non-survivors being significantly older, more frequently women, and having markedly higher percentages of the total body surface area (TBSA) affected. The mean age was 63 years and mean percentage of affected TBSA was 52%. The most frequent culprit drugs that caused TEN/SJS were allopurinol and metamizole, followed by various antibiotics. In 5.4% of the cases, no TEN/SJS-inducing suspect drug was identified. TEN/SJS present severe adverse cutaneous reactions that are marked by high in-hospital mortality rates. Age and TBSA were associated with poor prognosis. The range of possible trigger drugs that were associated with TEN/SJS was in agreement with previous reports.