Journal of Postgraduate Medicine, Education and Research

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VOLUME 48 , ISSUE 3 ( July-September, 2014 ) > List of Articles

REVIEW ARTICLE

Drugs Implicated, Mortality and Use of Corticosteroids in Toxic Epidermal Necrolysis Cases: A Systematic Review of Published Case Reports and Case Series

Sunil Dogra, Promila Pandhi, Sharonjeet Kaur, Sujit Rajagopalan, Anand Srinivasan

Citation Information : Dogra S, Pandhi P, Kaur S, Rajagopalan S, Srinivasan A. Drugs Implicated, Mortality and Use of Corticosteroids in Toxic Epidermal Necrolysis Cases: A Systematic Review of Published Case Reports and Case Series. J Postgrad Med Edu Res 2014; 48 (3):132-138.

DOI: 10.5005/jp-journals-10028-1118

Published Online: 01-09-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background

Toxic epidermal necrolysis (TEN) is a rare idiosyncratic mucocutaneous reaction associated with high mortality. Drugs are most commonly implicated in TEN. The treatment constitutes stopping the offending drug, along with symptomatic management. In this study, we searched for case reports/series of TEN and analyzed data to find the most commonly implicated drugs in TEN, effects of use of corticosteroids on mortality in TEN patients, changing trends in mortality over the past 3 decades and difference in mortality rates in both developing and developed countries.

Materials and methods

We searched for case reports/series of TEN to evaluate most commonly implicated drugs in TEN, effects of use of corticosteroids on mortality in TEN patients, changing trends in mortality over the past three decades and difference in mortality rates in both developing and developed countries.

Results

Antibiotics (28.6%) followed by antiepileptics (17.4%) and nonsteroidal anti-inflammatory drugs (9.6%) are most commonly implicated. There was nonsignificant decrease in mortality among steroids users as compared to nonusers (OR = 2.0, CI 0.96-4.24). During the period between 1980 and 1989 the reported mortality in TEN cases was approximately 33.4%, which decreased to 27% in the next two decades. There was a nonsignificant difference in mortality in develo- ping countries as compared to developed countries (OR: 0.70, CI 0.32-1.53).

Conclusion

Corticosteroids have been associated with non significant reduction in the mortality. Apart from this, mortality did not differ over years together in both developing and developed countries.

How to cite this article

Kaur S, Rajagopalan S, Shafiq N, Dogra S, Srinivasan A, Pandhi P, Malhotra S. Drugs Implicated, Mortality and Use of Corticosteroids in Toxic Epidermal Necrolysis Cases: A Systematic Review of Published Case Reports and Case Series. J Postgrad Med Edu Res 2014;48(3):132-138.


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