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The Incidence and Prevalence of Toxic Epidermal Necrolysis and Stevens-Johnson Syndrome in an HIV Population.

Neil H. Shear, MD., Sunnybrook Health Sciences Centre, Toronto, ON.

Toxic Epidermal Necrolysis (TEN) and Stevens Johnson Syndrome (SJS) are serious skin conditions that can cause painful rashes of the face, neck and torso but may also result in peeling of large quantities of the skin and the loss of finger nails, toe nails and eyebrows. In the general population approximately 0.4 to 1.2 per million people have TEN and 1 to 6 per million people have SJS. However, in the AIDS population, it has been reported that approximately 1 in 1000 individuals have TEN and SJS. The Ontario HIV Treatment Network (OHTN) collects data on individuals with HIV for the purposes of improving treatment and care for individuals with this condition. A preliminary search of the OHTN database, identified 9 cases of TEN/SJS out of a total of 3500 cases. Additional cases will be identified through a more formal search. In this study, a doctor specializing in skin disorders will confirm the TEN/SJS diagnosis reported on the database. Results will determine what drug most likely caused the TEN/SJS. This will be important in providing some information about HIV drugs that may cause TEN/SJS and may change the drugs selected by doctors to treat future patients.

Peer-reviewed publications supported by the Canadian Dermatology Foundation

Canadian Dermatology Foundation Grant	Peer- Reviewed Publication
Sulfamethoxazole-induced hypersensitivity syndromes: The role of patch testing as a diagnostic aid. (Sub-investigator) Schering Can.- Canadian Dermatology Foundation $10,000 2003-2004	Neuman MG, Shear NH, Malkiewicz IM, Taeri M, Shapiro LE, Krivoy N, Haber j, Gomez M, Fish J, Cartotto R, Cohen L. Immunopathogenesis of hypersensitivity syndrome reactions to sulfonamides. Translational Res 2007 (In press). Neuman MG, Shear NH, Malkiewicz IM, Taeri M, Shapiro LE, Krivoy N, Haber J, Gomez M, Fish J, Cartotto R, Cohen L. Immunopathogenesis of hypersensitivity syndrome reactions to sulfonamides. Translational Research 2007; 149: 243 – 253.
Abacavir hypersensitivity reaction: Investigations of immunopathogenesis and generalizability of diagnostic testing using cutaneous challenge, lymphocyte transformation and genetic testing (Prinicipal Investigator) Fujisawa Can.- Canadian Dermatology Foundation (CDF) $20,000 2004-2005	Phillips EJ, Wong GA, Kaul R, Shahabi K, Nolan DA, Knowles SR, Martin AM, Mallal S, Shear NH. Clinical and immunogenetic correlates of abacavir hypersensitivity. AIDS 2005; 19: 979 – 87.

©2008