1986 |
Guillaume et al. [6] |
Prospective, TEN |
13 years |
France |
87 |
Unknown |
Unknown |
Unknown |
Sulfonamides (20.7%) – sulfamethoxazole/trimethoprim (67%)Anticonvulsants (8%) – barbiturates and carbamazepine only NSAIDs (33.3%) -phenylbutazone, oxicam derivatives Allopurinol (3.4%) Chlormezanone (3.4%) |
Unknown |
1990 |
Chan et al. [79] |
Retrospective, EM/SJS/TEN |
14 years |
United States |
37 EM/SJS /TEN |
Unknown |
Unknown |
Unknown |
43% attributed to drugs Drug therapies with reaction rates in excess of 1 per 100 000 exposed individuals include phenobarbital (20 per 100 000), nitrofurantoin (7 per 100 000), sulfamethoxazole and trimethoprim, and ampicillin (both 3 per 100 000), and amoxicillin (2 per 100 000). |
Incidence of TEN alone due to all causes was 0.5 per 106 person-years. Incidence of EM, SJS, or TEN associated with drug use were 7.0, 1.8, and 9.0 per 106 person-years, respectively, for persons younger than 20 years of age, 20 to 64 years of age, and 65 years of age and older. |
1990 |
Schopf et al.[81] |
Retrospective, SJS/TEN |
5 years |
Germany |
259 TEN 315 SJS |
Mean age 63 years (TEN); 25 years (SJS) |
TEN: 2:1; SJS: 1:2 |
Unknown |
Antibiotics (TEN, 40%; SJS, 34%) Analgesics (TEN, 23%; SJS, 33%) |
TEN: Annual risk of 0.93 per million, mortality 34%SJS: Annual risk 1.1 per million, mortality 1% |
1990 |
Roujeau et al.[82] |
Retrospective, TEN |
5 years |
France |
399 TEN |
Unknown |
Unknown |
Unknown |
Sulfadiazine Isoxicam Oxyphenbutazone Phenytoin Fenbufen Cotrimoxazole |
Incidence 1.2 cases per million per year |
1993 |
Leenutaphong et al.[84] |
Retrospective, SJS and TEN |
9 years |
Thailand |
Total = 7858 SJS, 20 TEN |
Unknown |
Unknown |
Unknown |
Antibiotics (41%) – penicillin, sulfonamides, tetracycline, erythromycin Anticonvulsants (11.5%) – phenytoin, carbamazepine barbiturates Antitubercular drugs (10.3%) – thiacetazone |
Mortality rate 14%; 40% TEN, 5% SJS |
1995 |
Roujeau et al. [85] |
Retrospective, Case-control study |
4 years |
France, Germany, Italy, and Portugal |
Total = 245 SJS 89 SJS-TEN overlap 76 TEN 80 |
Unknown |
Unknown |
Unknown |
Sulfonamides, trimethoprim-sulfamethoxazole Carbamazepine Oxicam NSAIDs Chlormezanone Phenytoin Allopurinol |
Unknown |
1996 |
Rzany et al. [86] |
Retrospective, dZh German population-based registry for severe skin reactions. |
2 years 8 months |
Germany |
SJS 139 SJS-TEN overlap 95 TEN 56 |
Unknown |
Unknown |
Unknown |
Unknown |
Incidence of SJS/TEN Up to 1.89 per 1 million inhabitants per year |
1998 |
Kamaliah et al. [87] |
Retrospective, EM/SJS/TEN (EM excluded in this table) |
8 years |
East Malaysia |
Total = 2522 SJS, 3 TEN |
19 adult and 6 paediatric Paed: 10 month–12 years Adult: 15–65 years |
0.73:1 |
Fever (62.1%) Leukocytosis (34.5%) Hepatitis (31%) |
Antibiotics (36%) Cotrimoxazole Ampicillin/amoxicillin Anticonvulsants (32%) Allopurinol (4%) |
Mortality: TEN 37.3%, SJS 4.5% |
1999 |
Wong et al. [87] |
Retrospective, SJS/TEN |
12 years |
Australia |
Total = 1710 SJS, 7 TEN |
Mean age 61.5 years |
0.5:1 |
Unknown |
Betalactam antibiotics (52.9%) |
Mortality: 28.6% TEN 10% SJS |
2007 |
Gerdts et al. [89] |
Retrospective |
15 years |
The Netherlands |
19 |
Adult and paediatric Mean age 45.6 ± 23.9 years (5–70) |
1.6:1 |
Unknown |
Anticonvulsants – phenytoin/ carbamazepine (36.8%) Amoxicillin (10.5%) |
Mortality (15.8%) |
2007 |
Yamane et al. [90] |
Retrospective, all cases published from Japan |
6 years |
Japan |
Total = 11752 SJS, 65 TEN |
SJS: mean 45.2 years TEN: mean 45.7 years |
SJS 1.7:1 TEN |
Hepatitis (55.6%) Respiratory (25.6%) Renal dysfunction (19.7%) |
Anticonvulsants (17.9%) Antibiotics (17.1%) NSAIDs (12.8%) |
Mortality: SJS 1.9% TEN 6.2% |
2008 |
Sharma et al. [91] |
Retrospective |
3 years |
India |
Total = 3015 TEN, 9 SJS-TEN overlap and 6 SJS |
Paediatric and adult Mean age 22.3 ± 15.4 years (4–65) |
1.2:1 |
Haematological (86.7%) Hepatitis (36.7%) Renal (13.3%) Pnemonitis (10%) |
Anticonvulsants (35.1%) – phenytoin 45%, carbamazepine 30%Antibiotics (33.3%) – cephalosporins 26% NSAIDS (24.6%). |
Mortality 16.7% 13.3% TEN, 3.3% SJS-TEN overlap |
2008 |
Mockenhaupt et al. [92] |
Retrospective, case-control (EuroSCAR) |
Unknown |
Europe |
Total = 379 134 SJS, 136 SJS/TEN-overlap, 109 TEN |
Paediatric and adult Median 50 years (IQR 28–68) (1–95) |
1.6:1 |
Unknown |
Nevirapine Lamotrigine Carbamazepine Phenytoin Phenobarbital Cotrimoxazole and other anti-infective sulfonamides Sulfasalazine Allopurinol Oxicam-NSAIDs |
Unknown |
2010 |
Wetter et al. [93] |
Retrospective |
8 years |
United States |
27 SJS |
Paediatric and adult Mean 28.1 ± 22.3 years |
0.7:1 |
Fever (70%) Hepatitis (37%) Leukocytosis (22%) |
74% drug related Antibiotics (35%) – cotrimoxazole Anticonvulsants (35%) – phenytoin, lamotrigine NSAID (10%) |
Mortality 5% |