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Kirchhof, Mark G., MD, PhD; Miliszewski, Monica A., MD; Sikora, Sheena, MD; Papp, Anthony, MD, PhD; Dutz, Jan P., MD
Journal of the American Academy of Dermatology, 11/2014, Volume: 71, Issue: 5Journal Article
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. Limitations 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.
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