title: Aetiology in sixteen cases of toxic epidermal necrolysis and Stevens-Johnson syndrome admitted within eight months in a teaching hospital.
abstract: Toxic epidermal necrolysis and Stevens-Johnson syndrome are serious cutaneous reactions associated with significant mortality and morbidity. Eight patients with toxic epidermal necrolysis and eight patients with Stevens-Johnson syndrome were admitted consecutively to a single centre between August 2001 and March 2002. An aetiological study including viral serology and PCR was performed in view of the clustering of admissions related to these two conditions. The majority of cases were drug induced, the drug most commonly involved being allopurinol (toxic epidermal necrolysis, 50%; Stevens-Johnson syndrome, 13%). Two cases were related to drug abuse. Possible aetiological co-factors were cancers, radiotherapy and renal failure. No association with viral infection, including human herpesvirus-6 and parvovirus B19, was detected in the present series. Early diagnosis and prompt withdrawal of suspected drugs remain the most important measures in managing this condition. Further studies to identify the co-factors precipitating severe cutaneous drug reactions are warranted.
authors.affiliation: Department of Medicine, Queen Mary Hospital, The University of Hong Kong.
authors.forename: Chi Keung
authors.initials: CK
authors.lastname: Yeung
authors.forename: Shing Yan
authors.initials: SY
authors.lastname: Ma
authors.forename: Charmine
authors.initials: C
authors.lastname: Hon
authors.forename: Malik
authors.initials: M
authors.lastname: Peiris
authors.forename: Henry Hin Lee
authors.initials: HH
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced* / Q000209:etiology*