Diagnosis and Treatment of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis with Ocular Complications
Diagnosis and Treatment of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis with Ocular Complications
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DOI：
10.1016/j.ophtha.2008.12.048
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发表时间：
2009-04-01
期刊：
影响因子：
13.7
通讯作者：
Kinoshita, Shigeru
中科院分区：
文献类型：
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作者：
Sotozono, Chie;Ueta, Mayumi;Kinoshita, Shigeru
目的：详细阐述Stevens-Johnson综合征（SJS）及其更严重的变异型中毒性表皮坏死松解症（TEN）的发病症状及眼部并发症，并阐明局部使用类固醇与视力预后的关系。设计：横断面研究。参与者：94例SJS和TEN合并眼部并发症的患者。对在京都府立医科大学就诊的94例患者进行了结构化访谈、患者病历检查或两者兼而有之，以解决疾病发作时的临床表现。主要观察指标：前驱症状的发生率，前驱症状的详细情况，黏膜受累情况，以及局部使用类固醇与视力的关系。皮疹前75例，伴发高热86例。急性结膜炎和口腔和指甲受累的报告在所有患者谁记得的细节。急性结膜炎发生在皮疹之前42例，同时在21例，而只有1例患者报告后结膜炎。与未治疗组相比，接受局部类固醇治疗组的视力结果明显更好（P
Purpose: To present a detailed clarification of the symptoms at disease onset of Stevens-Johnson syndrome (SJS) and its more severe variant, toxic epidermal necrolysis (TEN), with ocular complications and to clarify the relationship between topical steroid use and visual prognosis.Design: Cross-sectional study.Participants: Ninety-four patients with SJS and TEN with ocular complications.Methods: A structured interview, examination of the patient medical records, or both addressing clinical manifestations at disease onset were conducted for 94 patients seen at Kyoto Prefectural University of Medicine. Any topical steroid use during the first week at the acute stage also was investigated.Main Outcome Measures: The incidence and the details of prodromal symptoms and the mucosal involvements and the relationship between topical steroid use and visual outcomes.Results: Common cold-like symptoms (general malaise, fever, sore throat, etc.) preceded skin eruptions in 75 cases, and extremely high fever accompanied disease onset in 86 cases. Acute conjunctivitis and oral and nail involvements were reported in all patients who remembered the details. Acute conjunctivitis occurred before the skin eruptions in 42 patients and simultaneously in 21 patients, whereas only 1 patient reported posteruption conjunctivitis. Visual outcomes were significantly better in the group receiving topical steroids compared with those of the no-treatment group (P