{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:13:44Z","timestamp":1783437224593,"version":"3.54.6"},"reference-count":18,"publisher":"PAGEPress Publications","issue":"2","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dermatol Reports"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.4081\/dr.2025.10275","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T08:32:46Z","timestamp":1752827566000},"source":"Crossref","is-referenced-by-count":0,"title":["Stevens-Johnson syndrome and toxic epidermal necrolysis in Saudi Arabia: a retrospective cross-sectional multicenter study"],"prefix":"10.4081","volume":"18","author":[{"given":"Rayan","family":"Alkhodair","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazeed","family":"Alowairdhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman","family":"Alfawzan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Alghamdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"41471","doi-asserted-by":"crossref","unstructured":"1. Correia O, Delgado L, Ramos JP, et al. Cutaneous T-cell recruitment in toxic epidermal necrolysis: further evidence of CD8+ lymphocyte involvement. Arch Dermatol 1993;129:466-8.","DOI":"10.1001\/archderm.1993.01680250078010"},{"key":"41472","doi-asserted-by":"crossref","unstructured":"2. Diphoorn J, Cazzaniga S, Gamba C, et al. Incidence, causative factors and mortality rates of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in northern Italy: data from the REACT registry. Pharmacoepidemiol Drug Saf 2016;25:196-203.","DOI":"10.1002\/pds.3937"},{"key":"41473","doi-asserted-by":"crossref","unstructured":"3. Rzany B, Mockenhaupt M, Baur S, et al. Epidemiology of erythema exsudativum multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis in Germany (1990-1992): structure and results of a population-based registry. J Clin Epidemiol 1996;49:769-73.","DOI":"10.1016\/0895-4356(96)00035-2"},{"key":"41474","doi-asserted-by":"crossref","unstructured":"4. Frey N, Jossi J, Bodmer M, et al. The epidemiology of Stevens-Johnson syndrome and toxic epidermal necrolysis in the UK. J Invest Dermatol 2017;137:1240-7.","DOI":"10.1016\/j.jid.2017.01.031"},{"key":"41475","doi-asserted-by":"crossref","unstructured":"5. Sekula P, Dunant A, Mockenhaupt M, et al. Comprehensive survival analysis of a cohort of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. J Invest Dermatol 2013;133:1197-204.","DOI":"10.1038\/jid.2012.510"},{"key":"41476","doi-asserted-by":"crossref","unstructured":"6. Halevy S, Ghislain PD, Mockenhaupt M, et al. Allopurinol is the most common cause of Stevens-Johnson syndrome and toxic epidermal necrolysis in Europe and Israel. J Am Acad Dermatol 2008;58:25-32.","DOI":"10.1016\/j.jaad.2007.08.036"},{"key":"41477","doi-asserted-by":"crossref","unstructured":"7. Mockenhaupt M, Viboud C, Dunant A, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: assessment of medication risks with emphasis on recently marketed drugs. The EuroSCAR study. J Invest Dermatol 2008;128:35-44.","DOI":"10.1038\/sj.jid.5701033"},{"key":"41478","doi-asserted-by":"crossref","unstructured":"8. Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T. Current perspectives on Stevens-Johnson syndrome and toxic epidermal necrolysis. Clin Rev Allergy Immunol 2018;54:147-76.","DOI":"10.1007\/s12016-017-8654-z"},{"key":"41479","doi-asserted-by":"crossref","unstructured":"9. Horne NS, Narayan AR, Young RM, Frieri M. Toxic epidermal necrolysis in systemic lupus erythematosus. Autoimmun Rev 2006;5:160-4.","DOI":"10.1016\/j.autrev.2005.10.003"},{"key":"41480","unstructured":"10. Alajaji A, Chandra Shekaran J, Mohammed Aldhabbah O, et al. Toxic epidermal necrolysis (TEN)\/Stevens-Johnson syndrome (SJS) epidemiology and mortality rate at King Fahad Specialist Hospital (KFSH) in Qassim region of Saudi Arabia:"},{"key":"41481","unstructured":"a retrospective study. Dermatol Res Pract 2020;1-3."},{"key":"41482","unstructured":"11. Nassar A, Eid E, Bastawi Y, Kalakatawy M. Efficacy of intravenous immunoglobulins for treatment of Stevens-Johnson syndrome, toxic epidermal necrolysis and their overlap. Gulf J Dermatol Venereol 2010;17."},{"key":"41483","doi-asserted-by":"crossref","unstructured":"12. Abou-Elhamd KEA. Two cases of Stevens-Johnson syndrome following intake of klavox with review of literature. Eur Arch Otorhinolaryngol 2009;266:1327-30.","DOI":"10.1007\/s00405-008-0785-7"},{"key":"41484","doi-asserted-by":"crossref","unstructured":"13. Elboraey MO, Essa EESF. Stevens-Johnson syndrome post second dose of Pfizer COVID-19 vaccine: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2021;132:e139.","DOI":"10.1016\/j.oooo.2021.06.019"},{"key":"41485","doi-asserted-by":"crossref","unstructured":"14. Mohammad Alfaleh A, Alajroush W, Alnami A. Fuchs syndrome: Stevens-Johnson Syndrome without skin manifestations in a child; a case report. Int J Med Dev Ctries 2020;4:853-6.","DOI":"10.24911\/IJMDC.51-1579413260"},{"key":"41486","doi-asserted-by":"crossref","unstructured":"15. Schwartz RA, McDonough PH, Lee BW. Toxic epidermal necrolysis: Part II. Prognosis, sequelae, diagnosis, differential diagnosis, prevention, and treatment. J Am Acad Dermatol 2013;69:187.e1-16.","DOI":"10.1016\/j.jaad.2013.05.002"},{"key":"41487","unstructured":"16. Gravante G, Delogu D, Marianetti M, et al. Toxic epidermal necrolysis and Steven Johnson syndrome: 11-years experience and outcome. Eur Rev Med Pharmacol Sci 2007;11:119."},{"key":"41488","doi-asserted-by":"crossref","unstructured":"17. Ferrandiz-Pulido C, Garcia-Patos V. A review of causes of Stevens\u2013Johnson syndrome and toxic epidermal necrolysis in children. 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