本研究收集成大醫院自開院始（77年7月）至93年7月止，十六年間經皮膚科醫師診斷為毒性表皮壞死鬆解症（toxic epidermal necrolysis, TEN）、史帝芬-強生氏症候群（Stevens-Johnson syndrome, SJS）及多形性紅斑（erythema multiforme, EM）之病患資料檔，且根據國際疾病分類（International classification of disease; ICD-9）代碼695.1，包括（staphylococcal scalded skin syndrome; 4S）、EM、SJS、TEN等，搜尋病患出院病歷診斷摘要，進行交叉比對。藉此了解其流行病學及致病因，特別是其與相關藥物的探討。回顧所有住院病患病歷共251人納入分析，其中毒性表皮壞死鬆解症48例，史帝芬-強生氏症候群88例，多形性紅斑115例，死亡率分別為毒性表皮壞死鬆解症14例（29%），史帝芬-強生氏症候群4例（4.5%），多形性紅斑2例（1.7%）。致病藥物種類以抗癲癇藥51例、非類固醇抗發炎藥39例及抗生素28例最常見，就藥物本身而言則以carbamazepine 35例、allopurinol 21例、phenytoin 12例及co-trimoxazole 8例發生比率最高。
 

Adverse cutaneous reactions to drugs are frequent, however, serious adverse cutaneous reactions are infrequent. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are a spectrum of the same disease. They are the more severe drug eruptions, with a mortality around 30% for TEN. We retrospectively study the severe cutaneous adverse reaction including, TEN, SJS and erythema multiforme (EM) during 16-year period (July 1988 to July 2004) at a tertiary hospital in southern Taiwan. A total of 251 cases were studies, including 48 TEN, 88 SJS and 115 EM. The mortality rate was 29% for TEN (14/48), 4.5% for SJS (4/88) and 1.7% for EM (2/115). The culprit drugs category most commonly were anticonvulsants (51 cases), nonsteroidal anti-inflammatory drugs (39 cases) and antibiotics (28 cases). The drugs with the highest estimated incidence include 35 cases of carbamazepine, 21 cases of allopurinol, 12 cases of phenytoin and 8 cases of co-trimoxazole. Prompt recognition of a severe drug reaction and withdrawal of the culprit drug is often the most important therapeutic action.