• Swosti Mohanty, Anupam Das, Anupama Ghosh, Amrita Sil, Ramesh Chandra Gharami, Debabrata Bandyopadhyay, and Nilay Kanti Das.
• Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India.
• Indian J Dermatol Venereol Leprol. 2017 May 1; 83 (3): 312-316.

BackgroundToxic epidermal necrolysis and Stevens-Johnson syndrome comprise life-threatening, drug-induced mucocutaneous disease spectrum. Interest in cyclosporine, a calcineurin inhibitor that can block the function of T-cells, has increased with the discovery of the importance of granulysin in apoptosis in toxic epidermal necrolysis. In our hospital, cyclosporine is given to Stevens-Johnson syndrome/toxic epidermal necrolysis patients as an adjunctive therapy.AimsThis study is an observational, record-based study comparing the effectiveness and safety of patients receiving cyclosporine versus only supportive therapy.MethodologyMedical records as bed-head tickets and laboratory investigation reports of Stevens-Johnson syndrome/toxic epidermal necrolysis patients admitted in the hospital over a period of 1 year were collected. Data regarding clinico-demographic profile, suspected drug causing Stevens-Johnson's syndrome/toxic epidermal necrolysis, SCORTEN, body surface area involved, treatment received and outcome were obtained.ResultsTwenty-eight patients were analyzed. Nineteen belonged to the cyclosporine group (supportive treatment + cyclosporine), nine to supportive treatment only group. Among the suspected drugs, antiepileptics formed the major group (28.6%). Five patients in the supportive only group and one in the cyclosporine group died. Time for stabilization and reepithelialization and duration of recovery were significantly lower in the cyclosporine group (P < 0.001, P= 0.007, P= 0.01, respectively). The standardized mortality ratio was 0.32 in cyclosporine group which is nearly 3.3 times lower than the only supportive treatment.LimitationsAs it was a record-based study, certain confounding factors (serum blood urea nitrogen) could not be adjusted.ConclusionCyclosporine (5 mg/kg/day) for 10 days from onset of Stevens-Johnson syndrome/toxic epidermal necrolysis may decrease the risk of dying, may provide faster healing of lesions and might lead to early discharge from hospital.

20 keywords...

hide…