Comparison of Cyclosporine with Systemic Corticosteroid in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis - A Pilot Study
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 5, Issue 11
Abstract
Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening dermatological emergencies. Many immunosuppressive modalities have been tried with variable results. Aims: This study aims to determine the efficacy of cyclosporine in cases of SJS and TEN and compare the efficacy with systemic corticosteroid in the same condition. Materials and Methods: The study was conducted at a tertiary hospital from January 2015 to December 2017. SCORTEN was assessed at the time of admission. Total body surface area assessment was like any burn patients. Cyclosporine was administered in the dose of 4 mg/kg body weight in two divided dosage for 7 days and then tapered over another 7 days. Data were compared to a similar control series of SJS/TEN patients, managed by systemic steroids in the same time period. Results: A total of 19 consecutive patients with a mean age of 32.09 and standard deviation ([SD] 16.17) were enrolled into cyclosporine group, which were compared to 19 patients with a mean age of 27.87 (SD 13.97) years in the corticosteroid group. The mean duration of reepithelialization was 14.54 (SD 4.08) and 23 days (SD 6.68) in cyclosporine and corticosteroid group, respectively. Mean hospital stay was 18.09 (SD 5.02) and 26 (SD 6.48) days in cyclosporine and corticosteroid group, respectively. Total mortality was 9. A total of 3 patients died in the cyclosporine group with 2 male and 1 female, compared to 6 deaths occured in corticosteroid group 4 female, 2 male. Conclusion: This study definitely suggests that cyclosporine has encouraging role in the management of uncomplicated cases of SJS, SJS-TEN overlap, or TEN, but randomized control trails are needed for further confirmation.
Authors and Affiliations
Singh Kumar Santosh, Ali Mohammad, Lalit Mohan, Anil Kumar Gupta, Dr Sushantika, Naveen Kumar
Keywords
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