Prognostic significance of the Systemic Immune-Inflammation Index in Steven-Johnson Syndrome and Toxic Epidermal Necrolysis (SJS/TEN) patients

Winn Hui Han; Tobias Tshung En Wong; Ruhana Che Yusof; Rebecca Kai Jan Choong; Shin Shen Yong; Nik Aimee Azizah Faheem; Zhenli Kwan

doi:10.1093/ced/llae332

Prognostic significance of the Systemic Immune-Inflammation Index in Steven-Johnson Syndrome and Toxic Epidermal Necrolysis (SJS/TEN) patients

Clin Exp Dermatol. 2024 Aug 16:llae332. doi: 10.1093/ced/llae332. Online ahead of print.

Authors

Winn Hui Han¹, Tobias Tshung En Wong¹, Ruhana Che Yusof², Rebecca Kai Jan Choong¹, Shin Shen Yong¹, Nik Aimee Azizah Faheem¹, Zhenli Kwan¹

Affiliations

¹ Division of Dermatology, Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
² Faculty of Medicine, University of Cyberjaya, Cyberjaya, Malaysia.

PMID: 39149846
DOI: 10.1093/ced/llae332

Abstract

Inflammatory markers such as neutrophil-lymphocyte ratio (NLR) and eosinophil count are known prognostic indicators for SJS/TEN severity. This study explored the correlation of systemic immune-inflammatory index (SII), platelet-lymphocyte ratio (PLR) and NLR with SCORTEN and patient outcomes. A retrospective audit of 34 SJS/TEN patients (25 SJS, 3 SJS/TEN overlap, 6 TEN) was conducted from 2018 to 2022 revealed mean admission values of SII 1597 (standard deviation (SD) 1904.18), NLR 6.52 (SD 5.99) and PLR 201.74 (SD 135.01). Cut-off values for predicting mortality were SII 1238.25 (area under ROC (AUROC) 0.82), NLR 8.32 (AUROC 0.8) and PLR 284.66 (AUROC 0.78). Multiple logistic regression using a backward stepwise method identified SCORTEN as a significant factor associated with mortality (p=0.029) after adjusting for SII, NLR and PLR. None of the inflammatory markers significantly predicted mortality, although admission PLR may be a potential risk factor (p=0.053).

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