{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T05:06:40Z","timestamp":1778648800916,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T00:00:00Z","timestamp":1581638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Stevens\u2010Johnson syndrome and toxic epidermal necrolysis represent important sources of potential mortality and morbidity in children. There is a need for more clinical data in this population to determine whether specific treatments preferentially improve outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center retrospective review of children admitted with drug\u2010induced Stevens\u2010Johnson syndrome, toxic epidermal necrolysis or Stevens\u2010Johnson syndrome\/toxic epidermal necrolysis overlap at a tertiary care pediatric institution in North America from 2008 to 2018. Patients without a dermatology assessment and diagnosis were excluded. Demographic, clinical, and treatment information were abstracted and reviewed for all included patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen patients were identified, 43% female (7\/16), with a mean age at presentation of 10.4\u00a0\u00b1\u00a05.2\u00a0years. Antibiotics were implicated in 56.3% of patients (9\/16) and anticonvulsants in 31.3% (5\/16). Sulfamethoxazole\u2010trimethoprim was the triggering antibiotic in 31.3% of patients. The majority of patients were treated with intravenous immunoglobulin alone (50%, 8\/16) or intravenous immunoglobulin with steroids (25%, 4\/16). Etanercept was added to intravenous immunoglobulin and corticosteroid in a 2\u2010year\u2010old patient, resulting in clinical stabilization and halting of epidermolysis. No patients died. Clinical sequelae were noted in five patients, including ocular complications (n\u00a0=\u00a04), labial adhesions (n\u00a0=\u00a01), and persistent skin dyspigmentation (n\u00a0=\u00a03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results highlight that sulfamethoxazole\u2010trimethoprim is an important cause of Stevens\u2010Johnson syndrome\u2010toxic epidermal necrolysis in children. Mortality was reassuringly low, but ocular sequelae were an important cause of morbidity. More data are needed to help determine whether specific treatments including etanercept may provide mortality or morbidity benefit in pediatric populations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.14118","type":"journal-article","created":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T16:48:45Z","timestamp":1581698925000},"page":"461-466","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Retrospective review of drug\u2010induced Stevens\u2010Johnson syndrome and toxic epidermal necrolysis cases at a pediatric tertiary care institution"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9288-1121","authenticated-orcid":false,"given":"Cathryn","family":"Sibbald","sequence":"first","affiliation":[{"name":"Section of Dermatology Department of Paediatrics SickKids Hospital Toronto Ontario"},{"name":"Department of Paediatrics University of Toronto Toronto Ontario"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3030-1483","authenticated-orcid":false,"given":"Elana","family":"Putterman","sequence":"additional","affiliation":[{"name":"Section of Dermatology Children's Hospital of Philadelphia Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Micheletti","sequence":"additional","affiliation":[{"name":"Section of Dermatology Children's Hospital of Philadelphia Philadelphia Pennsylvania"},{"name":"Department of Dermatology University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9945-8713","authenticated-orcid":false,"given":"James","family":"Treat","sequence":"additional","affiliation":[{"name":"Section of Dermatology Children's Hospital of Philadelphia Philadelphia Pennsylvania"},{"name":"Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3289-446X","authenticated-orcid":false,"given":"Leslie","family":"Castelo\u2010Soccio","sequence":"additional","affiliation":[{"name":"Section of Dermatology Children's Hospital of Philadelphia Philadelphia Pennsylvania"},{"name":"Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.12.024"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14799"},{"key":"e_1_2_6_4_1","first-page":"e121","article-title":"A systematic review of treatment of drug\u2010induced Stevens\u2010Johnson syndrome and toxic epidermal necrolysis in children","volume":"18","author":"Del Pozzo\u2010Magana BR","year":"2011","journal-title":"J Popul Ther Clin Pharmacol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2010.03935.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/BCR.0b013e31827a2ac3"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-016-0057-3"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2018.05.024"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2009.06.085"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI93349"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2018.12.018"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1203475418758989"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1203475419861078"},{"key":"e_1_2_6_14_1","volume-title":"Pediatric Dermatology Research Alliance","author":"Bahubeshi ARM","year":"2018"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.12482"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.13172"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2018.04.027"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-1923"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.13613"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtos.2016.02.001"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2017.04.002"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.5668"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028014560012"},{"key":"e_1_2_6_24_1","unstructured":"FoundationID.Characteristics of immunoglobulin products used to treat primary immunodeficiency diseases licensed for use in the United States.https:\/\/primaryimmune.org\/resource\/ivig-chart-22017. 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