Maria Aleshin, M.D., is Clinical Assistant Professor of Dermatology. Dr. Aleshin received her Bachelor of Arts degree from the University of California, Berkeley in 2009. She received her medical degree from the David Geffen School of Medicine at UCLA . She completed her dermatology residency at UCLA, where she also served as Chief Resident in her final year. Her clinical interests include general dermatology and inpatient dermatology.
Clinical Assistant Professor, Dermatology
Residency:UCLA Dermatology Residency (2018) CA
Internship:Kaiser Permanente Los Angeles Internal Medicine Residency (2015) CA
Medical Education:UCLA David Geffen School Of Medicine Registrar (2014) CA
Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: A Multicenter Retrospective Study of 377 Adult Patients from the United States
JOURNAL OF INVESTIGATIVE DERMATOLOGY
2018; 138 (11): 2315–21
Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a rare, severe mucocutaneous reaction with few large cohorts reported. This multicenter retrospective study included patients with SJS/TEN seen by inpatient consultative dermatologists at 18 academic medical centers in the United States. A total of 377 adult patients with SJS/TEN between January 1, 2000 and June 1, 2015 were entered, including 260 of 377 (69%) from 2010 onward. The most frequent cause of SJS/TEN was medication reaction in 338 of 377 (89.7%), most often to trimethoprim/sulfamethoxazole (89/338; 26.3%). Most patients were managed in an intensive care (100/368; 27.2%) or burn unit (151/368; 41.0%). Most received pharmacologic therapy (266/376; 70.7%) versus supportive care alone (110/376; 29.3%)-typically corticosteroids (113/266; 42.5%), intravenous immunoglobulin (94/266; 35.3%), or both therapies (54/266; 20.3%). Based on day 1 SCORTEN predicted mortality, approximately 78 in-hospital deaths were expected (77.7/368; 21%), but the observed mortality of 54 patients (54/368; 14.7%) was significantly lower (standardized mortality ratio = 0.70; 95% confidence interval = 0.58-0.79). Stratified by therapy received, the standardized mortality ratio was lowest among those receiving both steroids and intravenous immunoglobulin (standardized mortality ratio = 0.52; 95% confidence interval 0.21-0.79). This large cohort provides contemporary information regarding US patients with SJS/TEN. Mortality, although substantial, was significantly lower than predicted. Although the precise role of pharmacotherapy remains unclear, co-administration of corticosteroids and intravenous immunoglobulin, among other therapies, may warrant further study.
View details for PubMedID 29758282