To the Editor Dr Finkelstein and colleagues1 used hospital discharge data to determine the incidence and risk of recurrence of Stevens-Johnson syndrome and toxic epidermal necrolysis, which are rare serious conditions. The authors did not review medical records.
With expert review, only about 80% of prospectively ascertained cases diagnosed as Stevens-Johnson syndrome or toxic epidermal necrolysis had these diagnoses confirmed.2 The incidence of Stevens-Johnson syndrome and toxic epidermal necrolysis and the proportion of cases diagnosed as Stevens-Johnson syndrome in this study (750 hospitalized cases/13 million people over 10 years or 5.8 million person-years) are higher than in studies that included expert case review (0.4-1.2 per 1 million person-years for toxic epidermal necrolysis and 1-6 per 1 million person-years for Stevens-Johnson syndrome).2
Stern RS. Recurrence of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. JAMA. 2014;312(15):1590-1591. doi:10.1001/jama.2014.10777