Letter to the Editor re: ‘Long‐term complications of Stevens–Johnson syndrome/toxic epidermal necrolysis ( <scp>SJS</scp> / <scp>TEN</scp> ): the spectrum of chronic problems in patients who survive an episode of <scp>SJS</scp> / <scp>TEN</scp> necessitates multidisciplinary follow‐up’
Bibliographic record
Abstract
Dear Editor, We read with great interest, the review paper by Lee et al.1 on the long‐term complications of Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). We would like to congratulate the authors on this important and excellent overview. This review demonstrated that SJS/TEN has a severe, chronic phase with major physical morbidities. We wish to raise awareness of the major emotional complications among survivors, as was found in our study published in the British Journal of Dermatology by Dodiuk‐Gad et al.2 In our cohort of 17 survivors (11 females, 6 males) with a mean of 51·6 ± 74·7 months (median, 9; range, 1–228) following hospital discharge due to SJS/TEN, we found that 65% (11/17) of participants had symptoms of post‐traumatic stress, 53% (9/17) of participants reported at least moderate intrusion symptoms and 47% (8/17) reported at least a moderate level of avoidance and arousal symptoms. In addition, 29% (5/17) met the criteria for post‐traumatic stress disorder (PTSD). Seventy‐one per cent (12/17) of participants had scores indicating clinically significant psychological distress. Fifty‐three per cent (9/17) had scores expressing clinically significant anxiety and 29% (5/17) had scores demonstrating clinically significant depression. However, only 24% (4/17) of the participants had follow‐up by a mental health professional following hospitalization due to SJS/TEN.2 Table 6 in the review paper by Lee et al.1 includes the various chronic complications of SJS/TEN in different organs. We suggest adding PTSD as an important emotional complication in the psychiatric category. There is a demand for a shift in our approach to survivors of SJS/TEN by recognizing their challenging physical and emotional long‐term complications that necessitate multidisciplinary follow‐up. Further studies on SJS/TEN are needed in order to improve our understanding of the chronic phase of the disease and the treatment for survivors. No external funding. None declared.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.021 | 0.018 |
| Insufficient payload (model declined to judge) | 0.006 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".