WEDNESDAY, Oct. 2, 2024 -- The incidence of epidermal necrolysis (EN) is 2.6 cases per million person-years, but overall mortality is 34 percent, according to a study published online Oct. 2 in JAMA Dermatology.

Thomas Bettuzzi, M.D., M.P.H., from the Hôpital Henri Mondor in Créteil, France, and colleagues conducted a cohort study using French Health System data from Jan. 1, 2013, to Dec. 31, 2022, to assess the incidence of and compare factors associated with in-hospital and postdischarge mortality among patients with EN. Data were included for 1,221 adult patients with EN.

The researchers found that the incidence was 2.6 cases per million person-years. The in-hospital and postdischarge mortality rates were 19 and 15 percent, respectively, for an overall mortality of 34 percent. Factors associated with in-hospital mortality included age (adjusted hazard ratio [AHR], 1.03 per year of age), history of cancer (AHR, 2.04), dementia (AHR, 1.85), liver disease (AHR, 1.81), and EN severity (AHR, 2.14 for toxic epidermal necrolysis versus Stevens-Johnson syndrome). There was no association observed for EN initial severity with mortality after hospital discharge, but the associations for acute complications persisted (AHRs, 2.14 and 2.44 for acute kidney injury and sepsis, respectively). Ophthalmologic and mood disorders were the main sequelae.

"Despite EN being a rare condition, it is associated with high in-hospital and postdischarge mortality and a high burden of sequelae," the authors write.