Nadia Ali Azfar, Muhammad Ali Zia, Lamees Mahmood Malik, Abdur Rahim Khan, Muhammad Jahangir.
Comparison of methotrexate and azathioprine in the treatment of psoriasis: a randomized controlled trial.
J Pak Assoc Derma Jan ;20(3):152-62.

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are cutaneous adverse reactions which usually develop as a result of drug therapy. The role of systemic steroids in the treatment of SJS and TEN is debatable. Objective: To see the clinical outcome of patients suffering from SJS or TEN, treated with or without steroids. Patients and methods: Forty patients of SJS and TEN were enrolled from the inpatient department of Jinnah Hospital Lahore. Clinical data were recorded on a pro forma. Clinical outcome of patients treated with or without steroids was recorded and analyzed. Results: A total of forty patients were enrolled in the study. Twenty nine patients were suffering from SJS and 11 were suffering from TEN. Twenty three patients of SJS (79.31%) were treated without steroids. Two patients died (8.7%) and twenty one (91.30%) recovered. Six patients were given steroids (20.68%), out of these 2 (33.3%) died and 4 (66.76%) recovered. There were eleven patients of TEN, four (36.37%) were managed without steroids, one expired (25%) and rest of the three (75%) patients recovered. Seven (63.63%) patients were given steroids, three (43.86%) patients expired while four (57.14%) recovered.

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