Clinical clues predictive of Stevens-Johnson syndrome as the cause of chronic cicatrising conjunctivitis

Purpose This study aimed to identify the clinical clues in patients with chronic cicatrising conjunctivitis (CCC), that were suggestive of Stevens-Johnson syndrome (SJS) as the aetiology. Methods This was a cross-sectional observational study of 75 patients presenting with CCC from 2016 to 2018. Those with a documented diagnosis of SJS (n=43) were included as cases; while those with a positive serology or tissue biopsy for a non-SJS condition were included as controls (n=32). The features in the medical history and clinical examination that were positively and negatively associated with SJS were scored +1 and −1, respectively. A receiver operating characteristic (ROC) curve analysis was performed to detect the threshold score for optimal sensitivity and specificity of the scoring system. Results No single feature had absolute sensitivity and specify for SJS. The 10 positive features suggestive of SJS (p 5 showed a sensitivity of 90.7% and specificity of 93.8% for the diagnosis of SJS. Conclusions The combination of clinical clues identified in this study can help clinicians confirm SJS as the aetiology of conjunctival cicatrisation, especially when reliable documentation of the acute episode is not available.