Comparison of Complications and length of Hospitalization in management of Stevens-Johnson Syndrome with Systemic Steroid or Supportive Care

Stevens-Johnson syndrome (SJS) is a serious acute self limited emergency in dermatology with considerable morbidity and mortality, Its specific therapy with systemic steroids has been the matter of challenge and controversy in the past 4 decades. The purpose of this study was comparing of complications and the length of hospitalization between those treated with steroids and supportive care versus only supportive care measures. This is a cross-sectional study of 40 cases of SJS admitted to dermatology department of Razi Medical Center in Rasht in a 6 year period (1995-2001), evaluated with diagnostic criteria of: 1- Moderate to severe involvement of at least one issues. 2- Widespread involvement of the skin (mean 50% of skin surface) by lesions compatible with Erythema Multi form (EM), in two group of 20 patients, either on supportive care or supportive care with moderate doses of systemic steroids (0.5-1 mg/kg/day) (mean: 33mg prednisolone) The mean duration of hospitalization in supportive care group was 13.25 days while this period for systemic steroids group was 9.05 days (P<0.05) In steroid group,5patients and but in other group 8 patients were developed complication. It was not statistically significant. If systemic steroids begin soon (mean:3 day after appearance of rashes) with a moderate dose and short period, not only does not cause further complication but also reduce the length of hospitalization; in comparison to those on supportive care only. It is apparent that these data needs further prospective study for confirmation with regard to ethical limitation of prospective study in a rare emergency problem such as SJS.