The efficacy of corticosteroids, intravenous immunoglobulin,and cyclosporine in treating Stevens-Johnson Syndrome andToxic Epidermal Necrolysis in children: a systematic review
نویسندگان
1 Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Research Center of Artificial Intelligence in Health, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Department of Dermatology, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6 Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
7 Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
doi
10.22034/ijd.2025.550958.2115چکیده
Background: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening conditions that require prompt diagnosis and management. Therapeutic options include intravenous immunoglobulin (IVIG), systemic corticosteroids, and cyclosporine. Due to the limited data on SJS/TEN in children, we aimed to review the available therapeutic options for pediatric cases.Method: We searched PubMed/MEDLINE and Scopus using relevant keywords and MeSH terms for studies published between January 1, 2000, and March 30, 2021. Two researchers independently screened titles and abstracts to identify potentially eligible studies, and a third researcher reviewed the full texts of the selected studies to assess eligibility.Results: Our comprehensive search identified 3,098 individual studies. After full text screening, 24 articles met the eligibility criteria for inclusion. The number of pediatric patients with SJS, TEN, and SJS/TEN were 1021, 290, and 36, respectively. The most common etiologies were antiepileptic drugs (n = 142), antibiotics (n = 119), and NSAIDs (n = 19). Fever was present in 78% of patients, cutaneous rashes and mucosal involvement were each observed in 98%, oral involvement in 92%, ocular involvement in 69%, and genital involvement in 52%. Among the participants, 352 patients received IVIG, 305 received corticosteroids, and 144 were treated with a combination of IVIG + corticosteroids.Conclusion: Limited studies have examined the clinical findings and outcomes of SJS/TEN in children, with ongoing debate regarding the most effective treatment strategies. While some studies have reported improved clinical responses with IVIG and systemic corticosteroids, others have found no significant differences in outcomes between patients receiving supportive care and those undergoing systemic treatments.
