Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are both fatal dermatologic illnesses. The use of systemic corticosteroids as an additional treatment for SJS or TEN is still debatable. The purpose of this study was to see if early systemic corticosteroid therapy affects in-hospital mortality in patients with SJS or TEN.

Researchers identified patients aged more than or equal to 18 years, who were hospitalized with SJS or TEN using the Japanese Diagnosis Procedure Combination Database, which is a comprehensive statewide inpatient administrative claims database. Early systemic corticosteroid therapy was defined as starting treatment with systemic corticosteroids within 2 days after admission. In-hospital mortality was the main endpoint. Using propensity score (PS) analysis, they looked at the relationship between early systemic corticosteroids and in-hospital mortality.


They found 1846 eligible patients with SJS or TEN, including 793 with early systemic corticosteroid use of <= 2 mg/kg/day, 558 with early systemic corticosteroid use of >= to 2 mg/kg/day, and 495 without early corticosteroid use. PS matching resulted in 235 pairs (> 2 mg/kg/day vs. controls) and 332 pairs (≤ 2 mg/kg/day vs. controls) By PS matching (> 2 mg/kg/day vs. controls: RR 0.83, 95% [CI] 0.37–1.85; ≤ 2 mg/kg/day vs. controls: RR 0.61, 95% CI 0.28–1.36) and by inverse probability of treatment weighting (> 2 mg/kg/day vs. controls: RR 0.99, 95% CI 0.45–2.19; RR 0.65, 95% CI 0.29–1.47), early systemic corticosteroid use was not significantly associated with lower in-hospital mortality. 

More research is needed to determine the effect of corticosteroids on people with SJS or TEN.