title: Stevens-Johnson syndrome and toxic epidermal necrolysis in sub-Saharan Africa: a multicentric study in four countries.
abstract: OBJECTIVE
  The purpose of this study was to document the clinical profile, etiologies, and outcomes of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in hospitals in four sub-Saharan African countries.
  
  
  METHODS
  A retrospective study on cases of SJS/TEN treated in dermatology departments and/or intensive care units in four sub-Saharan African countries (Benin, Burkina Faso, Central African Republic, and Togo) from 2000 to 2010. The study focuses on variables such as age, sex, type of SJS/TEN, epidermal detachment of the skin surface, HIV status, drug(s) involved, and outcomes (death and sequelae).
  
  
  RESULTS
  This study identified 177 cases of SJS/TEN from 2000 to 2010: 129 with SJS; 37 TEN; and 11 overlapping SJS/TEN. The average age of patients was 32.3 ± 15.4 years, and the sex ratio (M/F) was 0.6. HIV serology was positive in 69 (54.8%) of the 126 patients tested. Antibacterial sulfonamides (38.4%) were the most commonly used drugs followed by nevirapine (19.8%) and tuberculosis drugs (5.6%). We recorded 22 deaths (i.e. six cases of SJS, 15 of TEN, and one of overlapping SJS/TEN). Of the 22 patients who died, 16 were infected with HIV; among them, seven had an opportunistic infection (four cases of cerebral toxoplasmosis and three of pulmonary tuberculosis). Twenty-seven cases of sequelae were noted with a large part of eye complications.
  
  
  CONCLUSIONS
  This study has highlighted: (i) the high proportion of patients infected with HIV among patients who had SJS/TEN in sub-Saharan Africa; (ii) the high frequency of antiretroviral drugs as new SJS/TEN causes in sub-Saharan Africa; and (iii) the impact of HIV infection on morbidity and mortality of these affections.
authors: Department of Dermatology, CHU Tokoin, University of Lomé, Lomé, Togo.
authors: Bayaki
authors: B
authors: Saka
authors: Fatou
authors: F
authors: Barro-Traoré
authors: Felix A
authors: FA
authors: Atadokpédé
authors: Léon
authors: L
authors: Kobangue
authors: Pascal Antoine
authors: PA
authors: Niamba
authors: Hugues
authors: H
authors: Adégbidi
authors: Hubert G
authors: HG
authors: Yedomon
authors: Adama
authors: A
authors: Traoré
authors: Vincent P
authors: VP
authors: Pitché
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D019380:Anti-HIV Agents / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000009:adverse effects*; D001927:Brain Diseases / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D005128:Eye Diseases / Q000209:etiology; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000009:adverse effects; D012189:Retrospective Studies; D013262:Stevens-Johnson Syndrome / Q000150:complications / Q000209:etiology*; D013449:Sulfonamides / Q000009:adverse effects; D016781:Toxoplasmosis, Cerebral / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents; D000995:Antitubercular Agents; D013449:Sulfonamides; D019829:Nevirapine