Table 2.
Outcome data stratified for phenotype
| Overall (n = 100) | DRESS (n = 50) | SJS/TEN (n = 39) | AGEP (n = 10) | p-value | |
|---|---|---|---|---|---|
| Did the patient receive medical treatment (Corticosteroids [systemic/topical], antiviral) | 95 (95%) | 45 (90%) | 39 (100%) | 10 (100%) | 0.097 |
| Treatment or supportive care | |||||
| Systemic corticosteroids | 77 (77%) | 42 (84%) | 29 (74%) | 5 (50%) | 0.066 |
| Topical corticosteroids | 79 (79%) | 39 (78%) | 30 (77%) | 9 (90%) | 0.82 |
| Antivirals | 8 (8%) | 2 (4%) | 6 (15%) | 0 (0%) | 0.14 |
| Antibiotics | 18 (18%) | 8 (16%) | 9 (23%) | 1 (10%) | 0.64 |
| Paracetamol | 37 (37%) | 16 (32%) | 19 (49%) | 1 (10%) | 0.052 |
| NSAIDS | 3 (3%) | 1 (2%) | 2 (5%) | 0 (0%) | 0.70 |
| Intravenous immunoglobulin | 18 (18%) | 3 (6%) | 15 (38%) | 0 (0%) | <0.001 |
| Plasma exchange | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | |
| Immunomodulatory therapy | 15 (15%) | 6 (12%) | 9 (23%) | 0 (0%) | 0.15 |
| Nasogastric feeding or TPN | 12 (12%) | 5 (10%) | 6 (15%) | 0 (0%) | 0.47 |
| Othera | 17 (17%) | 9 (18%) | 7 (18%) | 1 (10%) | 1.00 |
| Antiviral treatment | |||||
| Aciclovir (Intravenous) | 6 (6%) | 0 (0%) | 6 (15%) | 0 (0%) | 0.007 |
| Aciclovir (oral) | 1 (1%) | 0 (0%) | 1 (3%) | 0 (0%) | 0.49 |
| Valaciclovir | 4 (4%) | 2 (4%) | 2 (5%) | 0 (0%) | 1.00 |
| Immunomodulatory therapy | |||||
| Ciclosporin | 3 (3%) | 2 (4%) | 1 (3%) | 0 (0%) | 1.00 |
| Etanercept | 9 (9%) | 1 (2%) | 8 (21%) | 0 (0%) | 0.011 |
| Mepolizumab | 3 (3%) | 3 (6%) | 0 (0%) | 0 (0%) | 0.46 |
| Otherb | 2 (2%) | 2 (4%) | 0 (0%) | 0 (0%) | 0.60 |
| Supportive treatment types | |||||
| Nasogastric feeding | 3 (3%) | 0 (0%) | 3 (8%) | 0 (0%) | 0.13 |
| Parenteral feeding | 2 (2%) | 0 (0%) | 2 (5%) | 0 (0%) | 0.35 |
| Transfusion of blood products | 3 (3%) | 1 (2%) | 2 (5%) | 0 (0%) | 0.70 |
| Type of surgical treatment | |||||
| Skin debridement (ward) | 1 (1%) | 0 (0%) | 1 (3%) | 0 (0%) | 0.49 |
| Skin debridement (theatre) | 14 (14%) | 0 (0%) | 14 (36%) | 0 (0%) | <0.001 |
| Ophthalmic | 2 (2%) | 0 (0%) | 2 (5%) | 0 (0%) | 0.35 |
| None | 83 (83%) | 49 (98%) | 23 (59%) | 10 (100%) | <0.001 |
| Complications from treatment for SCAR | |||||
| Diabetes (including steroid-induced diabetes | 9 (9%) | 4 (8%) | 4 (10%) | 1 (10%) | 0.89 |
| Osteoporosis | 1 (1%) | 0 (0%) | 1 (3%) | 0 (0%) | 0.49 |
| Opportunistic infection | 7 (7%) | 0 (0%) | 7 (18%) | 0 (0%) | 0.003 |
| Death | 3 (3%) | 0 (0%) | 3 (7.7%) | 0 (0%) | 0 (0%) |
| None | 68 (68%) | 32 (64%) | 26 (67%) | 9 (90%) | 0.30 |
| Otherc | 8 (8%) | 5 (10%) | 3 (7.7%) | 0 (0%) | 0.47 |
| Length of stay (at participating site, from admission to discharge) (median,IQR) | 11 (6, 29) (n = 97) | 11 (7, 41) (n = 47) | 14 (7, 27) | 4 (2, 7) | 0.003 |
| Inpatient mortality | 7 (7%) | 0 (0%) | 7 (18%) | 0 (0%) | 0.003 |
| Did the patient die as a result of SCAR? | 4/7 (57%) | 0 (0%) | 4/7 (57%) | 0 (0%) | |
| Readmission 90 days | |||||
| No | 59 (59%) | 27 (54%) | 25 (64%) | 6 (60%) | 0.43 |
| Yes | 16 (16%) | 10 (20%) | 4 (10%) | 2 (20%) | |
| Unknown | 25 (25%) | 13 (26%) | 10 (26%) | 2 (20%) | |
| Readmission with complication of SCAR | 8 (8%) | 4 (8%) | 4 (10%) | 0 (0%) | 0.040 |
| Specialist outpatient follow up in 90 days post discharge? | |||||
| No | 22 (22%) | 8 (16%) | 10 (26%) | 3 (30%) | 0.47 |
| Yes | 67 (67%) | 35 (70%) | 26 (67%) | 6 (60%) | |
| Unknown | 11 (11%) | 7 (14%) | 3 (8%) | 1 (10%) | |
| Skin testing post discharge | |||||
| No | 49 (49%) | 20 (40%) | 24 (62%) | 4 (40%) | 0.039 |
| Yes | 28 (28%) | 18 (36%) | 6 (15%) | 4 (40%) | |
| Unknown | 23 (23%) | 12 (24%) | 9 (23%) | 2 (20%) | |
| Disability at 90 days19 | |||||
| No | 74 (74%) | 36 (72%) | 29 (74%) | 8 (80%) | 0.88 |
| Yes | 8 (8%) | 4 (8%) | 4 (10%) | 0 (0%) | |
| Unknown | 18 (18%) | 10 (20%) | 6 (15%) | 2 (20%) | |
| Mortality 90 days | |||||
| No | 75 (75%) | 40 (80%) | 26 (67%) | 8 (80%) | 0.022 |
| Yes | 11 (11%) | 2 (4%) | 9 (23%) | 0 (0%) | |
| Attributable to SCAR | 7/11 (64%) | 1/2 (50%) | 6/9 (67%) | 0 (0%) | |
| Unknown | 14 (14%) | 8 (16%) | 4 (10%) | 2 (20%) |
Abbreviations: AGEP, acute generalized oedematous pustulosis; SJS, Stevens Johnson Syndrome; TEN, toxic epidermal necrolysis; DRESS, drug reaction with eosinophilia and systemic symptoms; IQR, interquartile range; IV, intravenous; IVIG, intravenous immunoglobulin; TPN, total parental nutrition.
Paraffin ointment (n = 1), antihistamines (n = 3), skin emollient Dermeze/antihistamines (n = 1), opioids (n = 1), prednisolone vaginal suppository (n = 1), cetirizine/liquid paraffin (n = 1), etanercept (n = 4), vasopressor support (n = 1), IV methylprednisolone (n = 1), oral prednisolone/betamethasone ointment/dexamethasone mouthwash/mometasone lotion (n = 1).
Tacrolimus (n = 1), tacrolimus/mycophenolate (n = 1).
Hypertension/renal impairment (n = 1), Non-ST-Elevation Myocardial Infarction (NSTEMI)/ischaemic infarcts (n = 1), unknown (n = 1), hyperpigmentation/hyperhidrosis (n = 1), facial flushing/swelling/redness (n = 1), skin dyspigmentation/hair loss (n = 1), skin bruising (n = 1), abnormal LFT/hepatitis/peripheral neuropathy (n = 1).