Fatal Skin Disorder - Stevens Johnson Syndrome

Abstract

Toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS) are rare (one to two per 10, 00, 00 population per year) but life threatening adverse drug reactions. Drugs commonly implicated are anti-epileptics, anti-microbial and non-steroidal anti-inflammatory drugs (NSAIDS). Amongst anti-epileptics, carbamazepine and phenytoin are the major culprits.

 Stevens- Johnson syndrome or toxic epidermal necrolysis are potentially fatal skin disorders and the most severe forms of erythema multiforme. The diseases are mucocutaneous reactions that constitute a spectrum of reactions, with TEN being the most severe. The mortality rate from TEN is 30% to 35%. TEN and SJS are triggered by a reaction to medication. Antibiotics, specially sulfonamides, anti seizure agents, non- steroidal, anti- inflammatory drugs, and sulfonamides are the most frequent medications implicated. Most patients with TEN have an abnormal metabolism of the medication; the mechanism leading to TEN seems to be a cell- mediated cyto-toxic reaction.