Understanding the Gap Between Acute Complications and Long-Term Sequelae in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Bandung, West Java, Indonesia: Experience from Two Institutions.

INTRODUCTION

A severe skin reaction called Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) can cause a number of short-term and long-term problems that affect many organ systems.

OBJECTIVE

To describe acute complications and long-term sequelae in patients with SJS/TEN in two tertiary referral hospitals in West Java.

METHODS

A retrospective study was conducted in patients with SJS/TEN treated from January 1st, 2022, to July 31st, 2024, at Dr. Hasan Sadikin General Hospital Bandung and Cicendo Eye Hospital Bandung.

RESULTS

The study included a total of 28 patients, 11 males and 17 females. The study diagnosed patients with SJS (33%), SJS/TEN overlap (31%), or TEN (36%). The age range of the majority of patients was 25-44 years (32%). The most commonly implicated medication was acetaminophen, accounting for 43% of the cases. The average length of hospitalization for SJS was 8±3.29 days, for SJS/TEN overlap was 15.12±18.42 days, and for TEN was 13±9.01 days. The highest SCORTEN was 4. Among SJS and SJS/TEN overlap patients, cheilitis was the most frequent complication, while hypokalemia was the most common acute complication in TEN patients (17%). Long-term skin sequelae include hypopigmentation in five patients and hyperpigmentation in eleven. The most common long-term eye sequelae, dry eye, affected 3 patients.

CONCLUSION

Common acute complications include extensive cheilitis, hypoalbuminemia, hypocalcemia, acute conjunctivitis, and acute kidney injury. Hyperpigmentation and hypopigmentation were found as the most frequent long-term skin complications, and dry eyes were the most frequent long-term eye sequelae. Further studies on the physical sequelae of SJS/TEN are necessary to enhance our understanding of the condition and improve treatment for survivors.