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Severe ocular complications of SJS/TEN and associations among pre-onset, acute, and chronic factors: a report from the international ophthalmology collaborative group

 Mayumi Ueta  ;  Chikara Inoue  ;  Mitsuko Nakata  ;  Chie Sotozono  ;  Mee Kum Kim  ;  Tais Wakamatsu  ;  Passara Jongkhajornpong  ;  Hajirah Saeed  ;  Saaeha Rauz  ;  David Hui-Kang Ma  ;  Kyung Chul Yoon  ;  Vilavun Puangsricharern  ;  Charles Bouchard  ;  Sajjad Ahmad  ;  Kyoung Yul Seo  ;  Choun-Ki Joo  ;  Jose Alvaro Pereira Gomes  ;  James Chodosh  ;  Shigeru Kinoshita  ;  Satoshi Teramukai 
 FRONTIERS IN MEDICINE, Vol.10 : 1189140, 2023-06 
Journal Title
Issue Date
Stevens-Johnson syndrome (SJS) ; cold medicine ; common cold symptoms ; international research collaboration ; ocular sequelae ; onychopathy ; severe ocular complications (SOC) ; toxic epidermal necrolysis (TEN)
We formed an international research collaboration that included Japan, South Korea, Brazil, Thailand, Taiwan, the UK, and the US (682 patients from 13 hospitals between 2005 and 2020), to better evaluate the role of race, ethnicity, and other risk factors in the pathophysiology of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Ophthalmologists often see SJS/TEN patients with severe ocular complications (SOC; frequency 50% SJS/TEN patients) when the patients are referred to them in the chronic stage after the acute stage has passed. Global data were collected using a Clinical Report Form, capturing pre-onset factors, as well as acute and chronic ocular findings. Key conclusions of this retrospective observational cohort study were as follows: (1) Ingestion of cold medications [acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs)] was significantly and positively correlated with trichiasis, symblepharon, and/or conjunctivalization of the cornea in the chronic stage; (2) common cold symptoms prior to onset of SJS/TEN were significantly and positively correlated with acute conjunctivitis and ocular surface erosions in the acute stage and with trichiasis and symblepharon and/or conjunctivalization of the cornea in the chronic stage; (3) patients with SJS/TEN who presented with SOC tended to be female; (4) patients less than 30 years of age are more likely to develop SOC in the acute and chronic stages of SJS/TEN; (5) patients with acute severe conjunctivitis with ocular surface erosion and pseudomembrane formation in the acute stage are more likely to develop ocular sequelae in the chronic stage; and (6) onychopathy in the acute stage was positively correlated with ocular sequelae in the chronic stage. Our findings show that the ingestion of cold medications, common cold symptoms prior to the onset of SJS/TEN, and a young age might strongly contribute to developing the SOC of SJS/TEN.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Seo, Kyoung Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
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