{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:21:49Z","timestamp":1787764909522,"version":"build-2784847793"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>With limited data on the clinic-demographic profile of severe cutaneous adverse drug reactions (SCARs), this study aimed to analyze the clinical parameters, laboratory findings, mortality, and outcomes of SCARs in the Indian population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>A retrospective review was conducted for patients diagnosed with SCARs\u2014Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS)\u2014from January 2019 to June 2024. Clinical and investigational data of outpatient and hospitalized cases were obtained from medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Forty-nine cases of SJS-TEN and 115 cases of DRESS were analyzed. The mean age was 38.1 \u00b1 18.3 years (range 8\u201373) for SJS-TEN and 44.1 \u00b1 17.0 years (range 7\u201382) for DRESS. Antiepileptics were the most commonly implicated drugs in both groups (SJS-TEN: 51%; DRESS: 33%). Mortality was seen in 1\/115 in DRESS (hepatic involvement) and 10\/49 (20.4%) in SJS-TEN, with refractory septic shock being the most common cause in SJS-TEN. Key predictors of mortality in SJS-TEN included higher body surface area involvement, SCORe of toxic epidermal necrosis (SCORTEN) \u22652, systemic involvement, nasal mucosal involvement, and delayed presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations:<\/jats:title>\n                    <jats:p>This retrospective study had limitations, including polypharmacy in some patients, which limited the accuracy of causality assessment. Rechallenge was not performed due to ethical reasons, which may have affected drug identification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>SCARs contribute significantly to morbidity and mortality. Early diagnosis, prompt withdrawal of the culprit drug, and interdisciplinary management are essential. Patients should be educated about early warning signs, particularly when prescribed antiepileptics and nonsteroidal anti-inflammatory drugs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/idoj.idoj_522_25","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T17:00:20Z","timestamp":1771866020000},"page":"203-208","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Insights into Severe Cutaneous Adverse Drug Reactions: A 5-Year Retrospective Analysis of Stevens- Johnson Syndrome- Toxic Epidermal Necrolysis and Drug Rash with Eosinophilia and Systemic Symptoms"],"prefix":"10.4103","volume":"17","author":[{"given":"Muthu Sendhil","family":"Kumaran","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9495-7502","authenticated-orcid":false,"given":"Apoorva","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhdeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rucha","family":"Herlekar","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keshavamurthy","family":"Vinay","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0348-0815","authenticated-orcid":false,"given":"Davinder","family":"Parsad","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"R1-20260303","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1016\/S0140-6736(00)02799-9","article-title":"Adverse drug reactions: Definitions, diagnosis, and management","volume":"356","author":"Edwards","year":"2000","journal-title":"Lancet"},{"key":"R2-20260303","first-page":"292","article-title":"Cutaneous adverse drug reactions in hospitalized patients in a tertiary care center","volume":"36","author":"Noel","year":"2004","journal-title":"Indian J Pharmacol"},{"key":"R3-20260303","first-page":"16","article-title":"Adverse drug reactions among inpatients in a north Indian referral hospital","volume":"13","author":"Uppal","year":"2000","journal-title":"Natl Med J India"},{"key":"R4-20260303","first-page":"14","article-title":"Cutaneous adverse reactions in in-patients in a tertiary care hospital","volume":"65","author":"Jhaj","year":"1999","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R5-20260303","first-page":"20","article-title":"Adverse cutaneous drug reactions: Clinical pattern and causative agents in a tertiary care center in South India","volume":"70","author":"Pudukadan","year":"2004","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R6-20260303","doi-asserted-by":"crossref","first-page":"319","DOI":"10.2165\/11588460-000000000-00000","article-title":"Patient experiences of serious adverse drug reactions and their attitudes to medicines: A qualitative study of survivors of Stevens-Johnson syndrome and toxic epidermal necrolysis in the UK","volume":"34","author":"Butt","year":"2011","journal-title":"Drug Saf"},{"key":"R7-20260303","doi-asserted-by":"crossref","first-page":"S76","DOI":"10.4103\/2229-5178.146165","article-title":"Cutaneous adverse drug reactions in Indian population: A systematic review","volume":"5","author":"Patel","year":"2014","journal-title":"Indian Dermatol Online J"},{"key":"R8-20260303","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1111\/bjd.12501","article-title":"Drug reaction with eosinophilia and systemic symptoms (DRESS):An original multisystem adverse drug reaction. 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