title: Retrospective review of Stevens-Johnson syndrome/toxic epidermal necrolysis treatment comparing intravenous immunoglobulin with cyclosporine.
abstract: BACKGROUND
  Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are mucocutaneous reactions, typically to medications, that are associated with a high patient mortality. Controversy exists over which systemic treatments decrease mortality associated with SJS/TEN.
  
  
  OBJECTIVE
  In this study we sought to determine whether intravenous immunoglobulin (IVIg) or cyclosporine use for SJS/TEN results in better patient outcomes.
  
  
  METHODS
  We undertook a retrospective chart review of 71 patients admitted between 2001 and 2011 for SJS/TEN at a tertiary care center of which 64 cases were included in the data analysis. Predicted severity-of-illness score for TEN mortality was compared with actual mortality for patients treated with either cyclosporine or IVIg.
  
  
  RESULTS
  Our cohort demonstrated a relative mortality benefit to the use of cyclosporine in the treatment of SJS/TEN with a standardized mortality ratio of 0.43, over the use of IVIg with a standardized mortality ratio of 1.43.
  
  
  CONCLUSIONS
  This is single-center retrospective study.
  
  
  CONCLUSIONS
  The use of cyclosporine over IVIg may offer a greater mortality benefit in the treatment of SJS/TEN.
authors.affiliation: Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: kirchhof.mark@gmail.com.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Kirchhof
authors.affiliation: Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Monica A
authors.initials: MA
authors.lastname: Miliszewski
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Sheena
authors.initials: S
authors.lastname: Sikora
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Anthony
authors.initials: A
authors.lastname: Papp
authors.affiliation: Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Jan P
authors.initials: JP
authors.lastname: Dutz
mesh_terms: D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy*; D015996:Survival Rate
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D016572:Cyclosporine
keywords: Stevens-Johnson syndrome; cyclosporine; intravenous immunoglobulin; toxic epidermal necrolysis