PDF(Pubmed)
Abstract：
UNASSIGNED: Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe cutaneous adverse reactions of major concern because of its high mortality. The prognosis of SJS and TEN is widely assessed with SCORTEN (SCORe of TEN). Although, it is a largely useful scale, the predictive ability is still variable.
UNASSIGNED: This study was conducted to assess the clinicoetiological profile and outcome of SJS and TEN and to evaluate the validity of SCORTEN in assessing the prognosis in South Indian population.
UNASSIGNED: This prospective observational study was conducted in the Department of Dermatology, Venereology and Leprosy in a Tertiary care hospital from January 2016 to June 2017. Detailed history, examination findings, treatment and SCORTEN scores were recorded. SCORTEN\'s accuracy in predicting the mortality was assessed on day 1, 3 and 5 of admission.
UNASSIGNED: The incidence of SJS/TEN among other drug reactions was 29.5%. The most common age group affected was 30-49years (41.1%), with male preponderance (76.5%). The age range of patients was 6 and 67 years. TEN (64.7%) was the predominant spectrum followed by SJS and SJS-TEN overlap in 17.6% each. Anticonvulsants (47%) were the commonest causative drug, followed by analgesics (35%) and antibiotics (11%). The validity of SCORTEN was the same on days 1, 3, and 5. There was good agreement between the actual and predicted mortality on all three days. A mortality of 17.6% (3 cases) was recorded in this study. Three patients (17.6%) died in our study. All survivors had a score of 4 or less. The predicted mortalities were 0.417, 1.836, and 2.574 and the observed mortalities were 0, 2, and 1 in SJS, SJS-TEN overlap, and TEN respectively. Analysis of SCORTEN on a single day, either day 1, 3, or 5 was found to be as useful as the serial analysis.
UNASSIGNED: SCORTEN gave a significant estimation of mortality in SJS-TEN overlap patients, whereas it overestimated mortality in TEN patients. An increase in individual scores for the elevation of blood urea nitrogen (BUN) in existing SCORTEN and the inclusion of new parameters like raised liver enzymes, thrombocytopenia, and pulmonary infiltrates aided in proposing a modified SCORTEN for the South Indian population. Further studies on a larger scale, are needed to validate the modified SCORTEN proposed by us.
UNASSIGNED: This study was conducted to assess the clinicoetiological profile and outcome of SJS and TEN and to evaluate the validity of SCORTEN in assessing the prognosis in South Indian population.
UNASSIGNED: This prospective observational study was conducted in the Department of Dermatology, Venereology and Leprosy in a Tertiary care hospital from January 2016 to June 2017. Detailed history, examination findings, treatment and SCORTEN scores were recorded. SCORTEN\'s accuracy in predicting the mortality was assessed on day 1, 3 and 5 of admission.
UNASSIGNED: The incidence of SJS/TEN among other drug reactions was 29.5%. The most common age group affected was 30-49years (41.1%), with male preponderance (76.5%). The age range of patients was 6 and 67 years. TEN (64.7%) was the predominant spectrum followed by SJS and SJS-TEN overlap in 17.6% each. Anticonvulsants (47%) were the commonest causative drug, followed by analgesics (35%) and antibiotics (11%). The validity of SCORTEN was the same on days 1, 3, and 5. There was good agreement between the actual and predicted mortality on all three days. A mortality of 17.6% (3 cases) was recorded in this study. Three patients (17.6%) died in our study. All survivors had a score of 4 or less. The predicted mortalities were 0.417, 1.836, and 2.574 and the observed mortalities were 0, 2, and 1 in SJS, SJS-TEN overlap, and TEN respectively. Analysis of SCORTEN on a single day, either day 1, 3, or 5 was found to be as useful as the serial analysis.
UNASSIGNED: SCORTEN gave a significant estimation of mortality in SJS-TEN overlap patients, whereas it overestimated mortality in TEN patients. An increase in individual scores for the elevation of blood urea nitrogen (BUN) in existing SCORTEN and the inclusion of new parameters like raised liver enzymes, thrombocytopenia, and pulmonary infiltrates aided in proposing a modified SCORTEN for the South Indian population. Further studies on a larger scale, are needed to validate the modified SCORTEN proposed by us.
摘要：
■Stevens-Johnson综合征（SJS）和中毒性表皮坏死松解症（TEN）是严重的皮肤不良反应，因其死亡率高而备受关注。SJS和TEN的预后使用SCORTEN（TEN的SCORe）进行广泛评估。虽然,这是一个非常有用的量表，预测能力仍然是可变的。
■本研究旨在评估SJS和TEN的临床病因和结局，并评估SCORTEN在评估南印度人群预后中的有效性。
■这项前瞻性观察性研究是在皮肤科进行的，2016年1月至2017年6月，三级医院的性病和麻风病。详细的历史,检查结果，记录治疗和SCORTEN评分.在入院第1、3和5天评估SCORTEN预测死亡率的准确性。
■其他药物反应中SJS/TEN的发生率为29.5%。受影响最常见的年龄组是30-49岁(41.1%)，男性占优势（76.5%）。患者的年龄范围为6岁和67岁。TEN（64.7％）是主要的光谱，其次是SJS和SJS-TEN重叠，各占17.6％。抗惊厥药（47％）是最常见的致病药物，其次是镇痛药(35%)和抗生素(11%)。SCORTEN的有效性在第1、3和5天是相同的。在所有三天的实际死亡率和预测死亡率之间存在良好的一致性。本研究记录的死亡率为17.6%(3例)。我们的研究中有3名患者（17.6%）死亡。所有幸存者的得分为4分或更低。在SJS中，预测死亡率分别为0.417、1.836和2.574，观察死亡率分别为0、2和1。SJS-TEN重叠，分别为十。单日SCORTEN分析，发现第1天,第3天或第5天与系列分析一样有用.
■SCORTEN对SJS-TEN重叠患者的死亡率进行了重大估计，而它高估了TEN患者的死亡率。在现有的SCORTEN中，血液尿素氮（BUN）升高的个体得分增加，并纳入了新的参数，例如肝酶升高，血小板减少症,和肺浸润有助于为南印度人口提出改良的SCORTEN。更大规模的进一步研究，需要验证我们提出的修改后的SCORTEN。
■本研究旨在评估SJS和TEN的临床病因和结局，并评估SCORTEN在评估南印度人群预后中的有效性。
■这项前瞻性观察性研究是在皮肤科进行的，2016年1月至2017年6月，三级医院的性病和麻风病。详细的历史,检查结果，记录治疗和SCORTEN评分.在入院第1、3和5天评估SCORTEN预测死亡率的准确性。
■其他药物反应中SJS/TEN的发生率为29.5%。受影响最常见的年龄组是30-49岁(41.1%)，男性占优势（76.5%）。患者的年龄范围为6岁和67岁。TEN（64.7％）是主要的光谱，其次是SJS和SJS-TEN重叠，各占17.6％。抗惊厥药（47％）是最常见的致病药物，其次是镇痛药(35%)和抗生素(11%)。SCORTEN的有效性在第1、3和5天是相同的。在所有三天的实际死亡率和预测死亡率之间存在良好的一致性。本研究记录的死亡率为17.6%(3例)。我们的研究中有3名患者（17.6%）死亡。所有幸存者的得分为4分或更低。在SJS中，预测死亡率分别为0.417、1.836和2.574，观察死亡率分别为0、2和1。SJS-TEN重叠，分别为十。单日SCORTEN分析，发现第1天,第3天或第5天与系列分析一样有用.
■SCORTEN对SJS-TEN重叠患者的死亡率进行了重大估计，而它高估了TEN患者的死亡率。在现有的SCORTEN中，血液尿素氮（BUN）升高的个体得分增加，并纳入了新的参数，例如肝酶升高，血小板减少症,和肺浸润有助于为南印度人口提出改良的SCORTEN。更大规模的进一步研究，需要验证我们提出的修改后的SCORTEN。
