Clinical and Epidemiological Features of Patients with Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Iran: Different Points of Children from Adults

Background. Different epidemiologic aspects of drug-induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in children are scarce. Aim. To compare the clinical and epidemiological features of patients with drug-induced SJS and TEN in children and adults. Method. This retrospecti...

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Main Authors: Bahareh Abtahi-Naeini, Mohammad-sadegh Dehghan, Fatemeh Paknazar, Zabihollah Shahmoradi, Gita Faghihi, Ali Mohammad Sabzghabaee, Mojtaba Akbari, Mahdi Hadian, Tooba Momen
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:International Journal of Pediatrics
Online Access:http://dx.doi.org/10.1155/2022/8163588
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author Bahareh Abtahi-Naeini
Mohammad-sadegh Dehghan
Fatemeh Paknazar
Zabihollah Shahmoradi
Gita Faghihi
Ali Mohammad Sabzghabaee
Mojtaba Akbari
Mahdi Hadian
Tooba Momen
author_facet Bahareh Abtahi-Naeini
Mohammad-sadegh Dehghan
Fatemeh Paknazar
Zabihollah Shahmoradi
Gita Faghihi
Ali Mohammad Sabzghabaee
Mojtaba Akbari
Mahdi Hadian
Tooba Momen
author_sort Bahareh Abtahi-Naeini
collection DOAJ
description Background. Different epidemiologic aspects of drug-induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in children are scarce. Aim. To compare the clinical and epidemiological features of patients with drug-induced SJS and TEN in children and adults. Method. This retrospective study was conducted at two academic referral centers (Isfahan, Iran) over 5 years. SJS and TEN were clinically diagnosed and confirmed by skin biopsy as needed. Results. One hundred one patients (31 children and 70 adults) with a female to male ratio of 1.1 : 1 was identified in the present study. SJS was more commonly diagnosed in both pediatric and adult patients. The most frequent reason for drug administration identified was the infection (45.2%) and seizure (45.2%) in children and infection (34.3%) and psychiatry disorder (27.1%) in adults (P=0.001). The most common culprit drugs in the pediatric were phenobarbital (9/31), cotrimoxazole (4/31), and amoxicillin (4/31); however, in the adult group, the most common drugs were carbamazepine (11/70) and lamotrigine (9/70). Fever was significantly more common in adults (44.3%) compared to pediatric patients (22.6%) (P=0.03). Multiple logistic regression models showed that pediatric patients had significantly lower odds of hospitalization (OR [odds ratio]: 0.14; 95% CI 0.02, 0.67). In addition, patients with SCORTEN 1 had significantly higher odds of hospitalization (OR: 6.3; 95% CI: 1.68, 23.79) compared to patients with SCORTEN 0. Conclusions. The present study showed several differences between the pediatric and adult patients with SJS and TEN, including the reason for drug administration, culprit drugs, length of hospital stay, presence of fever, and final diagnosis of disease.
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spelling doaj-art-fbd474f0855f4dc2ac9343da71e4162a2025-02-03T05:45:00ZengWileyInternational Journal of Pediatrics1687-97592022-01-01202210.1155/2022/8163588Clinical and Epidemiological Features of Patients with Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Iran: Different Points of Children from AdultsBahareh Abtahi-Naeini0Mohammad-sadegh Dehghan1Fatemeh Paknazar2Zabihollah Shahmoradi3Gita Faghihi4Ali Mohammad Sabzghabaee5Mojtaba Akbari6Mahdi Hadian7Tooba Momen8Pediatric Dermatology Division of Department of PediatricsStudent Research CommitteeSocial Determinants of Health Research CenterSkin Diseases and Leishmaniasis Research CenterSkin Diseases and Leishmaniasis Research CenterIsfahan Clinical Toxicology Research CenterDepartment of EpidemiologySkin Diseases and Leishmaniasis Research CenterDepartment of Allergy and Clinical ImmunologyBackground. Different epidemiologic aspects of drug-induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in children are scarce. Aim. To compare the clinical and epidemiological features of patients with drug-induced SJS and TEN in children and adults. Method. This retrospective study was conducted at two academic referral centers (Isfahan, Iran) over 5 years. SJS and TEN were clinically diagnosed and confirmed by skin biopsy as needed. Results. One hundred one patients (31 children and 70 adults) with a female to male ratio of 1.1 : 1 was identified in the present study. SJS was more commonly diagnosed in both pediatric and adult patients. The most frequent reason for drug administration identified was the infection (45.2%) and seizure (45.2%) in children and infection (34.3%) and psychiatry disorder (27.1%) in adults (P=0.001). The most common culprit drugs in the pediatric were phenobarbital (9/31), cotrimoxazole (4/31), and amoxicillin (4/31); however, in the adult group, the most common drugs were carbamazepine (11/70) and lamotrigine (9/70). Fever was significantly more common in adults (44.3%) compared to pediatric patients (22.6%) (P=0.03). Multiple logistic regression models showed that pediatric patients had significantly lower odds of hospitalization (OR [odds ratio]: 0.14; 95% CI 0.02, 0.67). In addition, patients with SCORTEN 1 had significantly higher odds of hospitalization (OR: 6.3; 95% CI: 1.68, 23.79) compared to patients with SCORTEN 0. Conclusions. The present study showed several differences between the pediatric and adult patients with SJS and TEN, including the reason for drug administration, culprit drugs, length of hospital stay, presence of fever, and final diagnosis of disease.http://dx.doi.org/10.1155/2022/8163588
spellingShingle Bahareh Abtahi-Naeini
Mohammad-sadegh Dehghan
Fatemeh Paknazar
Zabihollah Shahmoradi
Gita Faghihi
Ali Mohammad Sabzghabaee
Mojtaba Akbari
Mahdi Hadian
Tooba Momen
Clinical and Epidemiological Features of Patients with Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Iran: Different Points of Children from Adults
International Journal of Pediatrics
title Clinical and Epidemiological Features of Patients with Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Iran: Different Points of Children from Adults
title_full Clinical and Epidemiological Features of Patients with Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Iran: Different Points of Children from Adults
title_fullStr Clinical and Epidemiological Features of Patients with Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Iran: Different Points of Children from Adults
title_full_unstemmed Clinical and Epidemiological Features of Patients with Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Iran: Different Points of Children from Adults
title_short Clinical and Epidemiological Features of Patients with Drug-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Iran: Different Points of Children from Adults
title_sort clinical and epidemiological features of patients with drug induced stevens johnson syndrome and toxic epidermal necrolysis in iran different points of children from adults
url http://dx.doi.org/10.1155/2022/8163588
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