Purchase this article with an account.
M. E. Morales, G. F. Purdue, S. M. Verity, B. D. Arnoldo, P. H. Blomquist; Ophthalmic Manifestations of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis and Relation to SCORTEN. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2385.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the severity of ocular involvement of patients with Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap, and to investigate the relationship of the SCORTEN (severity of illness score in SJS and TEN patients, which predicts mortality in the acute setting) with eye disease in this patient population.
This is a retrospective observational case series of 82 patients with a diagnosis of SJS, SJS/TEN overlap, or TEN. Charts of all patients admitted to the Parkland Memorial Hospital Burn Center with a preliminary diagnosis of SJS, SJS/TEN overlap, or TEN between 1998 and 2008 were reviewed. Patients were included for study if they met clinical criteria, had positive diagnostic skin biopsy, and had dermatologic and ophthalmologic consultations. Ocular manifestations were classified as mild, moderate or severe. Admission data were used to calculate the SCORTEN. The main outcome measures were the severity of ocular involvement with respect to diagnosis and SCORTEN.
Overall, 84% of patients had ocular involvement (71% SJS, 90% TEN, 100% SJS/TEN overlap). There was no difference in the severity of acute ocular complications among groups. While the SCORTEN value did correlate well with mortality rate (correlation coefficient 0.97, P= 0.005), there was no correlation between the SCORTEN value and severity of eye involvement in the acute setting. There was also no association of any individual diagnosis of SJS/Overlap/TEN with the severity of eye involvement, although eye findings are more common in TEN (P= 0.03).
Ocular damage in the acute setting was more frequent in patients with epidermal detachment > 10% of the total body surface area. The SCORTEN value did not correlate with the severity of eye involvement in the acute setting.
This PDF is available to Subscribers Only