Did Stanley et al. show a seven-fold rise in incidence of Stevens-Johnson syndrome & toxic epidermal necrolysis linked to the mRNA technology based COVID vaccine? Yes!

This is the largest case series exploring possible associations between COVID, the vaccine and SJS/TEN; Stevens-Johnson syndrome (SJS) / toxic epidermal necrolysis (TEN) is a rare, life threatening…

SOURCE:
https://www.sciencedirect.com/science/article/pii/S0305417923001286

Alexander COVID News-Dr. Paul Elias Alexander’s Newsletter is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

‘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.’
Researchers found ‘a seven-fold increase in SJS/TEN since the COVID pandemic. This increase correlates with an increase in COVID infections and vaccination rates.’
‘SJS/TEN is a rare, potentially life threatening mucocutaneous delayed hypersensitivity reaction [1]. It involves desquamation of the epidermis and mucosa. It is often drug related although may be triggered by infections. SJS/TEN is classified based on its percentage total body surface area (%TBSA) desquamation. SJS is less than 10 % TBSA, overlap SJS/TEN 10–30 % TBSA and TEN >30 % TBSA [2]. The estimated incidence is 1.6 (for SJS) – 9.2 (for TEN) cases per million per year worldwide [3] with a mortality rate of over 40 % in severe Case [4].’
‘We present a case series of eight patients diagnosed with COVID or having received the vaccine in the preceding month. All data collected was de-identifiable with all authors having access. Ethics approval was not required due to negligible risk. No funding was required with no conflicts of interest to declare.
4.1. Case 1

A 60-year-old female admitted with 55 % TBSA TEN (Fig. 1). COVID infection six weeks prior to onset. Received allopurinol for exacerbation of gout. Has previously taken allopurinol with no adverse effect. She was double vaccinated with a mRNA vaccine.

Download : Download high-res image (708KB)Download : Download full-size imageFig. 1. Toxic epidermal necrolysis Left: desquamation to back Right: frozen section demonstrating necrotic keratinocytes, full thickness epidermal necrosis and subepidermal bullae.

4.2. Case 2

A 78-year-old female admitted with 60 % TBSA TEN. COVID five weeks prior to onset. Developed COVID associated pneumonitis and received piperacillin/tazobactam. She was double vaccinated with a mRNA vaccine.
4.3. Case 3

A 54-year-old female admitted with 40 % TBSA TEN. COVID four weeks prior to onset. Developed COVID associated pneumonitis secondary to aspergillus. Received voriconazole. She was double vaccinated with a mRNA vaccine.
4.4. Case 4

A 26-year-old male admitted with 70 % TBSA TEN. Received a mRNA vaccine three weeks prior to onset. Due to vaccine associated symptoms, he took paracetamol and ibuprofen. He has previously taken paracetamol and ibuprofen with no adverse effect. He was triple vaccinated with previous two doses of a viral vector vaccine.
4.5. Case 5

A 45-year-old-male admitted with 70 % TBSA TEN. COVID infection four weeks prior to onset. Received levetiracetam for seizure prophylaxis post a traumatic subarachnoid haemorrhage. He was triple vaccinated with a mRNA vaccine.
4.6. Case 6

A 53-year-old-female admitted with 95 % TBSA TEN. Received a viral vector vaccine three weeks prior to onset. Quadruple vaccinated with previous doses of both viral vector and mRNA vaccines. Received captopril and amlodipine for scleroderma renal crisis.
4.7. Case 7

A 47-year-old male admitted with 10 % TBSA SJS/TEN overlap. COVID infection five weeks prior to onset. Received amoxycillin four weeks prior. Has previously taken amoxycillin with no adverse effect. Triple vaccinated with mRNA vaccine.
4.8. Case 8

A 53-year-old female admitted with 90 % TBSA TEN. Received a mRNA vaccine four weeks prior to onset. Triple vaccinated with mRNA vaccine. Received piperacillin/tazobactam for bacterial peritonitis. Has previously taken penicillins with no adverse effects.
5. Discussion

This is the largest case series exploring possible associations between COVID, the vaccine and SJS/TEN.’

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Author: Dr. Paul Alexander