1. Characterization of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis Among Patients Admitted to Kenyatta National Hospital: A Retrospective Cross-Sectional Study
- Author
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David G Nyamu, Kenneth Irungu, and Sylvia Opanga
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Pediatrics ,Nevirapine ,Cross-sectional study ,business.industry ,Human immunodeficiency virus (HIV) ,Stevens johnson ,Disease ,medicine.disease ,medicine.disease_cause ,Toxic epidermal necrolysis ,030207 dermatology & venereal diseases ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Pharmacotherapy ,Internal medicine ,medicine ,Etiology ,Pharmacology (medical) ,Original Research Article ,business ,medicine.drug - Abstract
Background Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous reactions. There is scant literature on the characteristics and causes of these conditions in Kenyatta National Hospital. Objective The aim of this study was to determine the prevalence, risk factors, and etiologies of SJS/TEN among patients admitted to Kenyatta National Hospital. Methods A retrospective cross-sectional study was done to find the characteristics and causes of severe cutaneous reactions among patients admitted to Kenyatta National Hospital. Universal sampling was employed, whereby all 115 patients with severe cutaneous reactions between June 2006 and June 2016 were studied. Information collected included participants’ sociodemographic variables, clinical characteristics of the disease, and the possible triggers. Data were analyzed using STATA version 13 at p ≤ 0.05. Results The mean age of patients was 31 years (±20). Low case numbers precluded statistically significant results; however, females represented 59.1% of patients, and 46.1% of patients were diagnosed between the ages of 21 and 40 years. SJS occurred in 47% of patients followed by TEN in 33.9% and SJS/TEN overlap in 19.1%. Drugs were determined to be the causative agent in 94.8% of the severe cutaneous reactions followed by infectious agents at 5.2%, principally HIV, herpes simplex virus 1, and mycoplasma. The most common drugs implicated were sulfonamides (26.1%) and nevirapine (15.7%). Conclusion Numerically, SJS was the most common subtype of SJS/TEN in Kenyatta National Hospital and was usually attributed to use of drugs, especially sulfonamides. Severe cutaneous reactions were observed more frequently in females and in patients aged between 21 and 40 years, indicating that emphasizing surveillance and medication counselling in these patient populations could be beneficial.
- Published
- 2017