Anda di halaman 1dari 15

Evaluation of the patients diagnosed

with Stevens
Johnson syndrome and toxic
epidermal necrolysis:
a single center experience
kr eki, Yakup Cantez, Nihat Sapan
Wahyu Widyastuti Ratnasari 1513010002
Elsandi Fiqri Firdaus 1513010009
Deby Wicaksono S 1513010023
Enrika Tunjung Puspita 1513010024
RD Selma Rachmawati B 1513010030
Prima Ufiyantama A S 1513010034
Rasi Irfan Asany 1513010036
Paramita Anindya Hapsari 1513010042
Dipa Andhika Harnolis 1513010046
Cory Dwi Rizki Octavianti 1513010048
Stevens Johnson syndrome (SJS) and toxic
epidermal necrolysis (TEN) are life-threatening,
delayed type hypersensitivity reactions.
Stevens Johnson syndrome and toxic epidermal
necrolysis are severe acute mucocutaneous
diseases.
AIM
In this study, it was aimed to evaluate the
clinical properties, etiologic factors, laboratory
data, therapies used and treatment responses in
the patients who were followed up with a
diagnosis of SJS, TEN and SJS/TEN overlap in the
last 5 years in our clinic.
Result
Result

The median period of maculopapular formation of vesicle


The median time for The median period of
Median age: 4 years Diagnosed drug usage before eruptions, mucositis in and/or bulla and epi-
recovery of the lesions hospitalization
presentation the mouth and eye dermal separation

-2 SJS
Female 54.5% (n=6) Male 45.4% (n=5) - 4 TEN 10 days 38 days 14 days all patient 10 patients
- 5 SJS/TEN
STRENGHNESS
Informed consent was obtained from the patients and
Ethics committee approval was received from Uluda
University School of Medicine Clinical.
Data in the table 1 was complete.

WEAKNESS
This study only held in Department of Pediatric Allergy
in Uluda University School of Medicine Clinical.
There are only 11 patients which evaluated in this study.
Discussion
It was difficult to specify the responsible drug,
because most of the patients were using multiple
drugs at the time of presentation in our study.
This result suggested that the possibility of
anticonvulsants to cause a severe picture was higher
compared to the other drugs.
There is still no consensus on a definite treatment method for
toxic epidermal necrolysis and SJS.
Systemic steroids and IVIG are used most frequently in
medical treatment and treatment options including
cyclosporine, plasmapheresis and hemodialysis are required
more rarely .
Kardaun et al, 2007 use of high dose corticosteroid for
short-term was helpful.

use of short-term corticosteroid


Roongpisuthipong et al, 2014 contributed to reduction in mortality
rates.

steroid treatment did not


Lehloenya R., 2007 contribute additionally to care
therapy.

In this study, methyl prednisolone was used at an initial dose of 0.5-2


mg/kg/day in all patients and then the dose was tapered (6-30 days).
It has been reported that use of intravenous immunoglobulin
at a dose of 2 g/kg is safe, but a dose higher than 2g/kg is
superior compared to a dose lower than 2 g/kg in terms of
positive effect.
Although the dose and duration of intravenous
immunoglobulin treatment varies by the severity of the
disease, it was used at a dose range of 2-3.5 g/kg/dose (2-9
days) in this study.
In this study, cyclosporine was used in one patient who did
not respons to supportive treatment, IVIG and cotricosteroid
treatment and a positive outcome was obtained.
Suggestion
Is expected in further research carried on many
hospital that more data to investigation broader.

In hopes to further research patients evaluated not


from a hospital it takes so could be known
prevalence of each region and hospital
Is expected in the next research can explain to best
assessment related SJS and NET
Conclusion
Anticonvulsants, antibiotics and non steroid anti-
inflammatory drugs play a major role in the etiology of
Stevens-Johnson syndrome and toxic epidermal
necrolysis. Anticonvulsants are associated with severe
disease. The patients with proper wound care and
treatment with immunosuppressive drugs can be
recovered without or with minimal sequelae.