Recommendations for Prevention of Drug Re-Exposure in Toxic Epidermal Necrolysis

J Drugs Dermatol. 2019 Oct 1;18(10):1049-1052.

Abstract

Drug re-exposure resulting in Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) is a rare phenomenon and has scarcely been reported. With an aging population, polypharmacy, and a lack of a unified electronic medical record, standard recommendations to prevent or minimize the risk of re-exposure are necessary. We identified five patients, with diagnosis confirmed SJS/TEN, and determined the clinical characteristics and contributing risk factors leading to re-exposure. Polypharmacy, multiple prescribers, advanced age, medical illiteracy, retention of discontinued medications and self-prescribing all contributed to re-exposure in this cohort of patients. This case series demonstrates the potentially deadly effect of drug re-exposure, and the need for both streamlined and integrated medication allergy documentation systems. J Drugs Dermatol. 2019;18(10):1049-1052.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Medical History Taking*
  • Medication Reconciliation*
  • Middle Aged
  • Retreatment / adverse effects
  • Risk Factors
  • Severity of Illness Index
  • Stevens-Johnson Syndrome / diagnosis
  • Stevens-Johnson Syndrome / etiology
  • Stevens-Johnson Syndrome / prevention & control*
  • Young Adult