title: Clinical features and prognostic factors in severe cutaneous drug reactions.
abstract: BACKGROUND
  Severe cutaneous adverse reactions (SCARs) include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). SJS and TEN (SJS/TEN) and DRESS are thought to be different diseases; however, they share some clinical and laboratory features. Although SCORTEN serves as an excellent prognostic marker for SJS/TEN, there is still a need for development of other prognostic markers for SCARs.
  
  
  METHODS
  The study population consisted of 88 SCAR patients. Clinical characteristics and clinical manifestations were compared between SJS/TEN and DRESS. Risk factor analyses for prolonged hospitalization were performed.
  
  
  RESULTS
  Of the 88 patients, 41 were SJS/TEN and 47 were DRESS. Mortality rates of TEN and DRESS were 9.8 and 2.1%, respectively. Allopurinol and carbamazepine were the most common causes of both SJS/TEN and DRESS (34.7 and 62.9%, respectively). Some of the systemic presentations, such as fever and laboratory abnormalities were common in both phenotypes. Thrombocytopenia tended to be related to prolonged hospitalization (longer than 3 weeks) in SJS/TEN (odds ratio, OR = 5.1, 95% confidence interval, CI 0.8-31.8, p = 0.076). In DRESS patients, leukocytosis at presentation (OR 4.8, 95% CI 1.1-20.3, p = 0.03) was related to prolonged hospitalization.
  
  
  CONCLUSIONS
  Clinical features of SCARs in a tertiary hospital in Korea were similar to those reported previously. SJS/TEN and DRESS shared some clinical and laboratory features. Thrombocytopenia for SJS/TEN and leukocytosis at presentation for DRESS may be useful prognostic markers for prolonged hospitalization.
authors.affiliation: Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Min-Suk
authors.initials: MS
authors.lastname: Yang
authors.forename: Min-Gyu
authors.initials: MG
authors.lastname: Kang
authors.forename: Jae-Woo
authors.initials: JW
authors.lastname: Jung
authors.forename: Woo-Jung
authors.initials: WJ
authors.lastname: Song
authors.forename: Hye-Ryun
authors.initials: HR
authors.lastname: Kang
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Cho
authors.forename: Kyung-Up
authors.initials: KU
authors.lastname: Min
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D004802:Eosinophilia / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007964:Leukocytosis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D013921:Thrombocytopenia; D055815:Young Adult