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  • Title: Retrospective review of Stevens-Johnson syndrome/toxic epidermal necrolysis treatment comparing intravenous immunoglobulin with cyclosporine.
    Author: Kirchhof MG, Miliszewski MA, Sikora S, Papp A, Dutz JP.
    Journal: J Am Acad Dermatol; 2014 Nov; 71(5):941-7. PubMed ID: 25087214.
    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. 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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