Understanding the Gap Between Acute Complications and Long-Term Sequelae in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Bandung, West Java, Indonesia: Experience from Two Institutions

Endang Sutedja,1 Oki Suwarsa,1 Miranti Pangastuti,1 Chaerani Pratiwi Firdaus,1 Reiva Farah Dwiyana,1 Trustia Rizqandaru,1 Arief Akhdestira Mustaram,2 Patriotika Muslima,2 Ayu Adzani Sabila1 1Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia; 2Department of Ophthalmology, Faculty of Medicine, Universitas Padjadjaran Cicendo Eye Hospital, Bandung, West Java, IndonesiaCorrespondence: Ayu Adzani Sabila, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Jl. Pasteur 38, Bandung, West Java, 40161, Indonesia, Tel +6282118094129, Email [email protected]: A severe skin reaction called Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) can cause a number of short-term and long-term problems that affect many organ systems.Objective: To describe acute complications and long-term sequelae in patients with SJS/TEN in two tertiary referral hospitals in West Java.Methods: A retrospective study was conducted in patients with SJS/TEN treated from January 1st, 2022, to July 31st, 2024, at Dr. Hasan Sadikin General Hospital Bandung and Cicendo Eye Hospital Bandung.Results: The study included a total of 28 patients, 11 males and 17 females. The study diagnosed patients with SJS (33%), SJS/TEN overlap (31%), or TEN (36%). The age range of the majority of patients was 25– 44 years (32%). The most commonly implicated medication was acetaminophen, accounting for 43% of the cases. The average length of hospitalization for SJS was 8± 3.29 days, for SJS/TEN overlap was 15.12± 18.42 days, and for TEN was 13± 9.01 days. The highest SCORTEN was 4. Among SJS and SJS/TEN overlap patients, cheilitis was the most frequent complication, while hypokalemia was the most common acute complication in TEN patients (17%). Long-term skin sequelae include hypopigmentation in five patients and hyperpigmentation in eleven. The most common long-term eye sequelae, dry eye, affected 3 patients.Conclusion: Common acute complications include extensive cheilitis, hypoalbuminemia, hypocalcemia, acute conjunctivitis, and acute kidney injury. Hyperpigmentation and hypopigmentation were found as the most frequent long-term skin complications, and dry eyes were the most frequent long-term eye sequelae. Further studies on the physical sequelae of SJS/TEN are necessary to enhance our understanding of the condition and improve treatment for survivors.Keywords: acute complications, long-term sequelae, Stevens-Johnson syndrome, toxic epidermal necrolysis