Facteurs de risque associés à la sévérité de l’atteinte oculaire au stade aigu du syndrome de Stevens-Johnson et de la nécrolyse épidermique toxique en Afrique subsaharienne

Saka, Bayaki; Dzidzinyo, K; Akakpo, S.; Teclessou, Julienne Noudé; Diori, Adam Nouhou; Maneh, Nidain; Mahamadou, G.; Gnassingbé, W.; Abilogun-Chokki, Aurel; Mouhari-Touré, A.; Boubacar, Y. Ali; Kombaté, K.; Balo, K.P.; Tchangaï-Walla, K.; Pitché, P.

doi:10.1016/j.annder.2018.01.040

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…The severity of the ocular involvement at the acute stage is already known as a factor conditioning the frequency and severity of ocular sequelae after skin scarring [14, 16, 17]. Exposure to sulfadoxine being a factor associated with the risk of ocular sequelae is not surprising since it is associated with the severity of the ocular involvement at the acute stage in sub-Saharan Africa [8]. Jongkhajornpong et al [18] found that exposure to antibiotics and to nonpharmaceutical triggers was a risk factor for ocular sequelae.…”

Section: Discussionmentioning

confidence: 99%

“…Ocular sequelae are dreadful and can lead to blindness; meanwhile, the mucocutaneous sequelae can alter the functional and social prognosis [3]. A previous research identified exposure to sulfadoxine as a factor associated with the severity of the ocular involvement at the acute stage SJS/TEN [8]. The aim of this study was to assess the ocular and mucocutaneous sequelae at the chronic phase and to identify the risk factors for ocular sequelae in sub-Saharan Africa.…”

Section: Introductionmentioning

confidence: 99%

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Ocular and Mucocutaneous Sequelae among Survivors of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Togo

Saka

Akakpo

Teclessou

et al. 2019

Dermatology Research and Practice

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Aim. The aim of this study was to assess ocular and mucocutaneous sequelae among SJS/TEN survivors and identify risk factors of ocular sequelae. Patients and Method. Late complications among SJS/TEN survivors were assessed using 2 methods: a retrospective assessment of medical records only or a retrospective assessment of medical records and physical examination of survivors who were contacted by phone. Results. Between January 1995 and December 2017, 177 cases of SJS/TEN (138 cases of SJS, 29 cases of TEN, and 10 cases SJS/TEN overlap) were admitted into two university hospitals of Lomé (Togo). There were 113 women and 64 men, with an average age of 31.7±13.0 years (range: 5 to 80 years). The most used drugs were antibacterial sulfonamides (35.6%) and nevirapine (24.3%). HIV serology was positive in 68 (59.1%) of the 115 patients tested. Sixty-four (52,5%) of the 122 patients, who had been examined by an ophthalmologist during the acute stage, had acute ocular involvement, which was mild in 27.9% of patients, moderate in 13.1%, and severe in 11.5%. We recorded 17 deaths (i.e., three cases of SJS, 12 of TEN, and two of SJS/TEN overlap), including 11 cases of HIV infected patients. Of the 160 SJS/TEN survivors, only 71 patients were assessed 6 months after hospital discharge. Among them, forty-three (60.6%) patients had sequelae. Concerning mucocutaneous sequelae, the main lesions were diffuse dyschromic macules (38.0% of patients) and ocular sequelae were dominated by decreased visual acuity (14.1% of patients). In multivariate analysis, exposure to sulfadoxine (odds adjusted ratio = 5.95; 95%CI= [1.36-31.35]) and moderate (adjusted odds ratio = 5.85; 95%CI = [1.23-31.81]) or severe (adjusted odds ratio = 48.30; 95%CI = [6.25-1063.66]) ocular involvement at acute stage were associated with ocular sequelae. Conclusion. Ocular and mucocutaneous sequelae are common in SJS/TEN survivors. Exposure to sulfadoxine and severity of acute ocular involvement are risk factors of ocular sequelae.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ocular and Mucocutaneous Sequelae among Survivors of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Togo

Saka

Akakpo

Teclessou

et al. 2019

Dermatology Research and Practice

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Clinical parameters and biological markers associated with acute severe ocular complications in Stevens-Johnson syndrome and toxic epidermal necrolysis

Panpruk

Puangsricharern

Klaewsongkram

et al. 2021

Sci Rep

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions with high mortality rates. Its sequelae, such as blindness, persist even after recovery. Patients with SJS/TEN should be accurately diagnosed and receive appropriate treatment as soon as possible. Therefore, identifying the factors for severity prediction is necessary. We aimed to clarify the clinical parameters and biological markers that can predict acute severe ocular complications (SOCs) in SJS/TEN. This retrospective cross-sectional study enrolled 47 patients with SJS/TEN who were divided into two groups according to ocular severity at acute onset: non-severe ocular complications group (n = 27) and severe ocular complications group (n = 20). Multivariate logistic regression analysis revealed that disease severity (body surface area detachment ≥ 10%) was a predictive factor for acute SOCs, and older age (≥ 60 years) was marginally significantly predictive of SOCs. Serum biomarker levels of S100A8/A9 and granulysin were marginally significant and tended to increase in the SOC group. Therefore, during the early acute stage, focusing on disease severity, patient age, and serum inflammatory biomarkers (S100A8/A9 and granulysin) might help predict SOC progression in patients with SJS/TEN who need prompt and aggressive ocular management to prevent severe ocular sequelae.

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Facteurs de risque associés à la sévérité de l’atteinte oculaire au stade aigu du syndrome de Stevens-Johnson et de la nécrolyse épidermique toxique en Afrique subsaharienne

Cited by 2 publications

References 11 publications

Ocular and Mucocutaneous Sequelae among Survivors of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Togo

Ocular and Mucocutaneous Sequelae among Survivors of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Togo

Clinical parameters and biological markers associated with acute severe ocular complications in Stevens-Johnson syndrome and toxic epidermal necrolysis

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