The seven-fold rise in incidence of Stevens-Johnson syndrome & toxic epidermal necrolysis: Associations with COVID-19 and the vaccine

Burns. 2024 Feb;50(1):87-92. doi: 10.1016/j.burns.2023.06.016. Epub 2023 Jun 28.

Edward A Stanley, Lois Zhang, Justine O'Hara, Peter Haertsch, Peter Maitz
Burns Unit, Concord Repatriation General Hospital, Sydney, Australia.

Abstract

Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) is a rare, potentially life threatening mucocutaneous hypersensitivity reaction resulting in desquamation of the skin and mucosa. These patients are managed on burns units due to the widespread desquamation. We report the largest case series of participants developing SJS/TEN in the setting of recent COVID infection or vaccination. We found a seven-fold increase in SJS/TEN since the COVID pandemic. This increase correlates with an increase in COVID infections and vaccination rates. We explore the immunopathological relationships between COVID and SJS/TEN and propose theories for possible associations.