Genitourinary involvement and management in children with Stevens-Johnson syndrome and toxic epidermal necrolysis

GU involvement in SJS/TEN occurred in almost three-quarters of patients and was managed conservatively like other skin/mucosal manifestations. Long-term sequelae were rare and urethral catheterization appeared to be safe, without any short-term or long-term complications.Summary Table. Genitourinary manifestations and management of Stevens-Johnson syndrome and toxic epidermal necrolysis in children.VariablesaOverallMalesFemalesP-value**N311615-Age at presentation, years0.62 Median (IQR)10.9 (7.4-14.1)10 (8-14)13 (6.7-14.5)Etiology of SJS0.68 Mycoplasma15 (48.4)9 (56.3)6 (40.0) Lamotrigine4 (12.9)1 (6.3)3 (20.0) Sulfamethoxazole/Trimethoprim4 (12.9)1 (6.3)3 (20.0) Azithromycin3 (9.7)2 (12.5)1 (6.7) Amoxicillin2 (6.5)1 (6.3)1 (6.7) Valproic acid1 (3.2)1 (6.3)0 (0) Recurrent SJS1 (3.2)0 (0)1 (6.7) Unknown1 (3.2)1 (6.3)0 (0)Signs/Symptoms Dysuria20 (64.5)10 (62.5)10 (66.7)1.00 Hematuria1 (3.2)1 (6.3)0 (0)1.00 Urinary retention5 (16.1)3 (18.8)2 (13.3)1.00 Scrotal/labial lesions11 (35.5)5 (31.3)6 (40.0)0.72 Penile/vulvar lesions18 (58.0)7 (43.8)11 (73.3)0.15 Meatal lesions12 (38.7)9 (56.3)3 (20.0)0.07 Acute kidney injury1 (3.2)1 (6.3)0 (0)1.00Management Urology consult12 (38.7)7 (43.8)5 (33.3)0.72 Foley urethral catheter8 (25.8)4 (25.0)4 (26.7)1.00 Topical petroleum jelly20 (64.5)9 (56.3)11 (73.3)0.46 Phenazopyridine3 (9.7)3 (18.8)0 (0)0.23 Topical lidocaine1 (3.2)1 (6.3)0 (0)1.00 Surgery1 (3.2)1 (6.3)0 (0)0.49Long-term complications Penile/labial adhesions3 (9.7)1 (6.3)2 (13.3)1.00SJS = Stevens-Johnson syndrome; TEN = toxic epidermal necrolysis; IQR = interquartile range.∗∗P-values compared males vs. females with Wilcoxon rank-sum test for age and Fisher's exact test for all other variables.aValues shown are number (%) unless otherwise specified.