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Clinical and Epidemiological Features of Patients With Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Iran: Different Points of Children From Adults Publisher



Abtahinaeini B1, 2 ; Dehghan MS3 ; Paknazar F4 ; Shahmoradi Z2 ; Faghihi G2 ; Sabzghabaee AM5 ; Akbari M6 ; Hadian M2 ; Momen T7
Authors
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Authors Affiliations
  1. 1. Pediatric Dermatology Division, Department of Pediatrics, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
  5. 5. Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  6. 6. Department of Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
  7. 7. Department of Allergy and Clinical Immunology, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

Source: International Journal of Pediatrics (United Kingdom) Published:2022


Abstract

Background. Different epidemiologic aspects of drug-induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in children are scarce. Aim. To compare the clinical and epidemiological features of patients with drug-induced SJS and TEN in children and adults. Method. This retrospective study was conducted at two academic referral centers (Isfahan, Iran) over 5 years. SJS and TEN were clinically diagnosed and confirmed by skin biopsy as needed. Results. One hundred one patients (31 children and 70 adults) with a female to male ratio of 1.1: 1 was identified in the present study. SJS was more commonly diagnosed in both pediatric and adult patients. The most frequent reason for drug administration identified was the infection (45.2%) and seizure (45.2%) in children and infection (34.3%) and psychiatry disorder (27.1%) in adults (P=0.001). The most common culprit drugs in the pediatric were phenobarbital (9/31), cotrimoxazole (4/31), and amoxicillin (4/31); however, in the adult group, the most common drugs were carbamazepine (11/70) and lamotrigine (9/70). Fever was significantly more common in adults (44.3%) compared to pediatric patients (22.6%) (P=0.03). Multiple logistic regression models showed that pediatric patients had significantly lower odds of hospitalization (OR [odds ratio]: 0.14; 95% CI 0.02, 0.67). In addition, patients with SCORTEN 1 had significantly higher odds of hospitalization (OR: 6.3; 95% CI: 1.68, 23.79) compared to patients with SCORTEN 0. Conclusions. The present study showed several differences between the pediatric and adult patients with SJS and TEN, including the reason for drug administration, culprit drugs, length of hospital stay, presence of fever, and final diagnosis of disease. © 2022 Bahareh Abtahi-Naeini et al.
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