Risk factors for Stevens — Johnson syndrome and toxic epidermal necrolysis

Background. Stevens — Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but severe immune-mediated adverse skin reactions, most commonly caused by drug products or infections. Objective. To study the risk factors of SJS and TEN development in patients who were on inpatient treatment in the department of allergology of the City Clinical Hospital № 21 of the Republic of Bashkortostan in 2014—2023. Material and methods. A retrospective analysis of the case histories of 229 patients, considering the affected area of the body’s surface, was carried out. Patients were divided into 3 groups: 83 had SJS, 41 — SJS/TEN combination, 105 — TEN. The following parameters were analyzed with regard to the risk of developing SJS and TEN: age and sex, past medical history and concomitant diseases prior application of drug products, maximum detachment of the epidermis as a percentage of the body’s affected area. Results. Cardiovascular diseases (CVDs) (14.5%), gastrointestinal diseases (8.4%) and diabetes mellitus (6%) were risk factors for SJS development; CVDs (24.4%), peripheral vascular disease (14.6%) and diabetes mellitus (12.2%) — risk factors for SJS/TEN development; diabetes mellitus (16.2%), CVDs (12.4%), HIV (9.5%) and malignant tumors (9.5%) — risk factors for developing TEN. Drug products were the cause of SJS and SJS/TEN development (48.2 and 48.8%, respectively). Pharmaceuticals (63.8%) and viral infection (22.9%) were mainly the etiological factor of TEN development. Conclusion. The presence of HIV, malignant neoplasms and diabetes mellitus are more significant for patients with TEN. Peripheral vascular disease is more common in patients with SJS/TEN than with TEN. Drug products and viral infection were etiologically more significant for TEN than for SJS and SJS/TEN; in contrast, the cause of disease could not be identified more often in patients with SJS and SJS/TEN.