Severe cutaneous drug reactions (Stevens-Johnson syndrome and toxic epidermal necrolysis) in human immunodeficiency virus infection

Abstract

To the Editor.— Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) represent severe forms of cutaneous drug reactions. There have been 23 cases of these reactions reported in human immunodeficiency virus (HIV)-infected persons, six in the United States and 17 in Europe.1-6We report an additional eight cases, seven with acquired immunodeficiency syndrome (AIDS) and one with acquired immunodeficiency syndrome-related complex, seen at the University of California San Francisco-affiliated hospitals in 3.5 years (Table). The patients were gay males, one of whom was also an intravenous drug user (case 8). Helper T-cell counts (available in five patients) were below 100 × 109cells per liter. All cases were related to drug exposure, and occurred from 1 to 21 days (median, 8.0 days) after the implicated drug wasinitiated. Two of the patients developed reactions while hospitalized (cases 2 and 8). The eight patients had all received multiple medications,