Stevens-Johnson syndrome and toxic epidermal necrolysis in Saudi Arabia: a retrospective cross-sectional multicenter study

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are a spectrum of life-threatening mucocutaneous conditions. Despite having a lower incidence rate than other dermatological conditions, SJS/TEN has a high mortality rate. SJS/TEN is usually caused by newly administered medications, particularly antibacterials and anticonvulsants. Little research data on SJS/TEN in Saudi Arabia has been published. We aimed to bridge this gap by reviewing and investigating the etiologies, risk factors, interventions, and outcomes of patients diagnosed with SJS/TEN. This is a retrospective cross-sectional study conducted in National Guard Hospitals in Riyadh and Jeddah from January 2015 to July 2023. We reviewed all dermatology medical records diagnosed as SJS/TEN through clinical assessment and histopathology, confirmed by a dermatology consultant. Additionally, we excluded all non-Saudi patients and those referred to our center with outside reports without histopathology from the national guard hospitals. This study included 25 patients diagnosed with the SJS/TEN spectrum between January 2015 and July 2023. Nearly two-thirds of the patients were male (n=15, 60%), and the average age was 45.96 years. Almost half of the culprit agents were antibiotics. Six of the 25 patients died (24%). Four were males, all over 50 years old, and one female was 6 years old. All these patients had TEN, except for one with SJS. Septic shock was the cause of death in 4 patients. Given the evident high risk for patients contracting this condition, prospective research and analysis to understand the correlation between SJS/TEN, mortality, and treatment are warranted.