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November 2009

The Management of Severe Ocular Complications of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Arch Dermatol. 2009;145(11):1336-1337. doi:10.1001/archdermatol.2009.293

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are recognized as 2 of the most devastating ocular surface diseases, and they are extremely difficult to treat both at the acute and later stages. Massive inflammation on the ocular surface at the acute stage is often uncontrollable. Even after the acute-stage impairments subside, ocular complications such as serious visual impairment with dry eye and keratinization remain. With these facts in mind, we read with great interest the article titled “Risk Factors for the Development of Ocular Complications of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis,” by Gueudry et al,1 in which the authors assert that the only significant risk factor of late ocular involvement of SJS and TEN is the severity of initial eye involvement. In their report, they suggest that the use of systemic and local corticosteroids might not be able to prevent late ocular complications. However, we believe that the authors should not draw such a conclusion because topical corticosteroid treatment was used in only 1 case in their study.

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