Are Multimorbidities Underestimated in Scoring Systems of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Like in SCORTEN?

Overview

Journal Eplasty

Specialty General Surgery

Date 2012 Aug 23

PMID 22912906

Citations 4

Authors

Tobias von Wild

Peter L Stollwerck

Thomas Namdar

Felix H Stang

Peter Mailander

Frank Siemers

Affiliations

Soon will be listed here.

Abstract

Objective: Toxic epidermal necrolysis and Stevens-Johnson syndrome have related high morbidity and mortality. We predict that preexisting multimorbidity is a major prognostic factor of both these diseases.

Methods: A retrospective analysis in toxic epidermal necrolysis and Stevens-Johnson syndrome patients over the past 10 years. Three severity categories (minor, moderate, and severe multimorbidity) were defined according to a point-rating system.

Results: Twenty-seven inpatients, with a median age of 63 years, diagnosed with toxic epidermal necrolysis (n = 13) or Stevens-Johnson syndrome/toxic epidermal necrolysis (n = 14) were assessed in this study. Of these, 14 patients died during the course of the study. Nonsurvivors showed significantly higher multimorbidity (P = .038), with higher scoring on the points system for disease severity (P = .003), than survivors and CART (Classification and Regression Trees) cross-validation (P < .05).

Limitations: Restricted number of patients due to low prevalence rate.

Conclusion: The complexity of associated multimorbidity appears to have a large influence on toxic epidermal necrolysis and Stevens-Johnson syndrome prognosis, which has not been considered in any of the established scoring systems.

Citing Articles

Intravenous Immunoglobulin Combined With Corticosteroids for the Treatment of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: A Propensity-Matched Retrospective Study in China.

Yang L, Shou Y, Li F, Zhu X, Yang Y, Xu J Front Pharmacol. 2022; 12:750173.

PMID: 35115922 PMC: 8804212. DOI: 10.3389/fphar.2021.750173.

Cutaneous Drug Reactions in the Elderly.

Young J, Shear N Drugs Aging. 2017; 34(9):655-672.

PMID: 28801750 DOI: 10.1007/s40266-017-0483-5.

Clinical characteristics and treatment outcome of Stevens-Johnson syndrome and toxic epidermal necrolysis.

Chantaphakul H, Sanon T, Klaewsongkram J Exp Ther Med. 2015; 10(2):519-524.

PMID: 26622347 PMC: 4509461. DOI: 10.3892/etm.2015.2549.

Stevens-Johnson syndrome / toxic epidermal necrolysis: an Asia-Pacific perspective.

Thong B Asia Pac Allergy. 2013; 3(4):215-23.

PMID: 24260726 PMC: 3826606. DOI: 10.5415/apallergy.2013.3.4.215.

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