A Population-Based Study of Stevens-Johnson Syndrome

Abstract

To determine the incidence of Stevens-Johnson syndrome, a descriptive epidemiology study was performed using computerized Medicaid billing data from 1980 to 1984 from the states of Michigan, Minnesota, and Florida. The ratio of persons hospitalized with a discharge diagnosis of erythema multiforme (ICD-9-CM code 695.1) to persons with any claim for medical service was first used as an estimate of the incidence rate of the disease. Then, since the ICD-9-CM code for erythema multiforme includes other illnesses in addition to Stevens-Johnson syndrome and because these illnesses are frequently misdiagnosed, the information provided by a review of medical records for a subset of cases of erythema multiforme was used to determine the proportion of patients with true Stevens-Johnson syndrome. The incidence rates of Stevens-Johnson syndrome were 7.1 (6.1 to 8.2), 2.6 (1.6 to 4.0), and 6.8 (4.3 to 10.3) per million per year in each state, respectively. Penicillins, especially aminopenicillins, were frequently used in the 19 patients judged to be true cases of Stevens-Johnson syndrome. In conclusion, Stevens-Johnson syndrome is a uncommon condition. The excess risk of Stevens-Johnson syndrome due to any drug must, therefore, be very low.

A systematic review of the drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Indian population

“…Incidence of SJS and TEN is 2.6-7.1 persons per million populations per year in United States. [1,2] It is 1.1 and 0.93 per million per year for SJS and TEN respectively in Germany. [3] Drugs are most commonly implicated for causing 77-95% of cases.…”

Nevirapine-induced Stevens-Johnson syndrome following HIV postexposure prophylaxis

“…SJS is a hypersensitivity reaction that typically involves the skin and mucous membranes and has an incidence of 2.6 cases per million population per year 7. SJS and severe drug eruptions have been reported following treatment with nevirapine in HIV-infected patients.…”

Drug induced exfoliative dermatitis: state of the art

“…Albeit the lack of epidemiologic data regarding EM, its reported prevalence is less than 1 % [7–10]. Several authors report the incidence of hospitalization for EM ranging from 0.4–6 cases per million people per year of northern Europe [11] to almost 40 cases per million people per year of United States [12]. EM usually occurs in young adults of 20–40 years of age [13], with women affected more frequently than men (1.5:1.0) [14].…”