Combination therapy in the treatment of Stevens-Johnson syndrome/toxic epidermal necrolysis: a case series and review of literature

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening disease of skin and mucous membrane that are mostly caused by drugs. Many studies have focussed on treatment that modify immunologic responses like corticosteroid, IVIG, cyclosporine, biologics like TNF-α inhibitors etanercept, infliximab etc. But there are few studies available on using two immunomodifier drugs simultaneously. However, no standardized treatment protocol has been established for SJS/TEN patients. We present a case-series of 10 SJS-TEN patients treated with both systemic corticosteroid and cyclosporine. We provide a review of literature on individual systemic corticosteroid, cyclosporine and also simultaneous use of both agents for SJS/TEN, including various outcome measures-stabilization, mortality rate, hospital length of stay and comparison to other systemic agents.