Faculty Collaboration Database

Seasonal variation of Stevens-Johnson syndrome and toxic epidermal necrolysis associated with trimethoprim-sulfamethoxazole. J Am Acad Dermatol 2009 Apr;60(4):589-94

Date

02/17/2009

Pubmed ID

19217690

DOI

10.1016/j.jaad.2008.11.884

Scopus ID

2-s2.0-61849156846 (requires institutional sign-in at Scopus site)   36 Citations

Abstract

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and severe cutaneous adverse reactions to medications and infections.

OBJECTIVE: We sought to determine whether a seasonal variation to SJS and TEN exists and to define the characteristics in our tertiary referral hospital.

METHODS: A retrospective chart review of 50 patients from 1995 through 2007 was performed and statistically analyzed.

RESULTS: The most common medication implicated as a cause of SJS/TEN was trimethoprim-sulfamethoxazole (TMX) (26%). A seasonal trend, favoring springtime, was observed for the total number of cases of SJS and TEN (P = .34). There was a significant increase in cases due to TMX (53%) occurring in spring compared to other seasons (P = .002). These patients were significantly younger (37.8 +/- 13.7) than other patients with SJS and TEN (53.7 +/- 16.4) (P = .003). Their overall mortality (1 death) and average SCORTEN value (1.62 +/- 1.6) was also significantly lower (P = .04 and 0.03, respectively). Based on outpatient pharmacy records, there was no increase in TMX prescriptions filled during the spring.

LIMITATIONS: The study was limited by reliance on chart data, the use of inpatient records, and number of patients.

CONCLUSIONS: A seasonal variation in SJS and TEN caused by TMX affecting younger patients may exist.

Author List

Wanat KA, Anadkat MJ, Klekotka PA

Author

Karolyn A. Wanat MD Chair, Professor in the Dermatology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Anti-Infective Agents
Female
Humans
Male
Middle Aged
Retrospective Studies
Seasons
Stevens-Johnson Syndrome
Trimethoprim, Sulfamethoxazole Drug Combination
Young Adult