Severe Physical Complications among Survivors of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
Severe Physical Complications among Survivors of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
复制标题
DOI：
10.1007/s40264-017-0608-0
复制
发表时间：
2018-03-01
期刊：
影响因子：
4.2
通讯作者：
Dodiuk-Gad, Roni P.
中科院分区：
文献类型：
--
作者：
Olteanu, Cristina;Shear, Neil H.;Dodiuk-Gad, Roni P.
史蒂文斯-约翰逊综合征(SJS)和中毒性表皮坏死松解症(TEN)幸存者之间的身体并发症的研究很少。本研究的目的是全面地描述SJS/TEN幸存者的身体并发症的特征，并了解患者对SJS/TEN幸存者的看法。我们的队列包括17名患者，平均51.6+/-74.7个月(中位数9个月，范围1-228个月)。在医学检查中发现的最常见的身体并发症是炎症后皮肤变化(77%)、皮肤疤痕(46%)、干眼(44%)、睑粘连和慢性眼表炎症(各占33%)。新的身体后遗症包括慢性疲劳(76%)和瘙痒(53%)。我们还发现在SJS/TEN急性期受影响的粘膜数量与出院后6个月内脱发之间存在新的关联；在有三个或更多粘膜受累的患者组中，88%的患者脱发，而在受影响的黏膜少于三个的患者中，脱发的比例为29%(p=0.0406)。在因SJS/TEN出院后，59%的患者接受了皮肤科医生的治疗，尽管88%有皮肤科并发症；6%的患者接受了眼科医生的治疗，尽管67%有眼科并发症；6%的女性幸存者接受了妇科医生的治疗，尽管27%有妇科并发症。SJS/TEN的幸存者遭受着严重的身体并发症，这些并发症影响了她们的健康和生活，这些并发症大多没有得到医疗专业人员的充分认识和治疗。
Few studies have reported the physical complications among Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) survivors.The aim of this study was to comprehensively characterize the physical complications among SJS/TEN survivors and to learn about patients' perspectives of surviving SJS/TEN.SJS/TEN survivors older than 18 years of age were assessed by different methods: a medical interview; a questionnaire assessing patients' perspectives; thorough skin, oral mucous membrane, and ophthalmic examinations; and a retrospective assessment of medical records.Our cohort consisted of 17 patients with a mean time of 51.6 +/- 74.7 months (median 9, range 1-228) following SJS/TEN. The most common physical complications identified in the medical examination were post-inflammatory skin changes (77%), cutaneous scars (46%), dry eyes (44%), symblepharon, and chronic ocular surface inflammation (33% each). Novel physical sequelae included chronic fatigue (76%) and pruritus (53%). We also found a novel association between the number of mucous membranes affected in the acute phase of SJS/TEN and hair loss during the 6 months following hospital discharge; hair loss was reported in 88% of the group of patients who had three or more mucous membranes affected versus 29% of patients who had less than three mucous membranes involved (p = 0.0406). Following hospital discharge due to SJS/TEN, 59% of patients were followed by a dermatologist, although 88% had dermatological complications; 6% were followed by an ophthalmologist, even though 67% had ophthalmological complications; and 6% of female survivors were followed by a gynecologist, even though 27% had gynecological complications.Survivors of SJS/TEN suffer from severe physical complications impacting their health and lives that are mostly under recognized and not sufficiently treated by medical professionals.