• Mark G Kirchhof, Monica A Miliszewski, Sheena Sikora, Anthony Papp, and Jan P Dutz.
• Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: kirchhof.mark@gmail.com.
• J. Am. Acad. Dermatol. 2014 Nov 1; 71 (5): 941-7.

BackgroundStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are mucocutaneous reactions, typically to medications, that are associated with a high patient mortality. Controversy exists over which systemic treatments decrease mortality associated with SJS/TEN.ObjectiveIn this study we sought to determine whether intravenous immunoglobulin (IVIg) or cyclosporine use for SJS/TEN results in better patient outcomes.MethodsWe undertook a retrospective chart review of 71 patients admitted between 2001 and 2011 for SJS/TEN at a tertiary care center of which 64 cases were included in the data analysis. Predicted severity-of-illness score for TEN mortality was compared with actual mortality for patients treated with either cyclosporine or IVIg.ResultsOur cohort demonstrated a relative mortality benefit to the use of cyclosporine in the treatment of SJS/TEN with a standardized mortality ratio of 0.43, over the use of IVIg with a standardized mortality ratio of 1.43.LimitationsThis is single-center retrospective study.ConclusionsThe use of cyclosporine over IVIg may offer a greater mortality benefit in the treatment of SJS/TEN.Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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