Disseminated intravascular coagulation in Stevens-Johnson syndrome and toxic epidermal necrolysis.

Abstract Background Patients with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) had high mortality rates. Disseminated intravascular coagulation (DIC) has been reported in SJS/TEN patients. The influence of this lethal complication in patients with SJS/TEN is not well known. Objective This study aimed to investigate the risk and outcomes of DIC in patients with SJS/TEN. Methods We analyzed the DIC profiles of patients diagnosed with SJS/TEN between 2010 and 2019. Results We analyzed 150 patients with SJS/TEN (75 SJS, 22 overlapping SJS-TEN, and 53 TEN) and their complete DIC profiles. DIC was diagnosed in 32 patients (21.3%), primarily those with TEN. DIC was significantly associated with systemic complications, including gastrointestinal bleeding, respiratory failure, renal failure, liver failure, infection, and bacteremia. Additionally, SJS/TEN patients with DIC had elevated procalcitonin. Among patients with SJS/TEN, DIC was associated with a >10-fold increase in mortality (78.1% vs. 7%). Limitations The study limitations include small sample size and single hospital system Conclusion DIC is a potential complication of SJS/TEN and associated with higher mortality. Early recognition and appropriate management of this critical complication are important for patients with SJS/TEN.