Analysis of Current Treatments and Deceased Cases of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Japan

Abstract

To examine the current treatments for Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in Japan, we retrospectively analyzed reports of 43 cases of SJS and 54 cases of TEN published in medical journals from 2000 to 2005. Corticosteroid was administered systemically in most cases, and methylprednisolone (mPSL) pulse therapy (1,000 mg/day) or mini pulse (less than 600 mg/day) was selected for 14 cases (32.6%) of SJS and 28 cases (51.9%) of TEN. Combinations of plasmapheresis or high-dose immunoglobulin therapy with corticosteroid therapy were performed in 5 cases of TEN and 3 cases of TEN. In 2 cases of TEN in which the symptoms continued to progres in spite of using corticosteroids and high-dose immunoglobulin therapy, plasmapheresis was performed additionally and was effective in their recovery. This suggests that the combination of these 3 treatments may be useful in seriously ill patients. The mortality rate of patients with SJS was 2.3%, and with TEN was 7.4%. We also reviewed the deceased cases published in medical journals from 2000 to 2005. One case of SJS and 4 cases of TEN were reported.