Prognosis and medical history of severe cutaneous adverse reactions (SJS, TEN, DIHS)

• Project/Area Number: 18K10075
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
• Research Institution: Juntendo University
• Principal Investigator: Kurosawa Michiko 順天堂大学, 医学部, 准教授 (70245702)
• Project Period (FY): 2018-04-01 – 2024-03-31
• Project Status: Completed (Fiscal Year 2023)
• Budget Amount: ¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000); Fiscal Year 2020: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2019: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000); Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
• Keywords: SJS / TEN / DIHS / レセプトデータ / 重症薬疹 / 既往歴 / データベース / 予後 / 後遺症

Outline of Final Research Achievements

Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug-induced hypersensitivity syndrome (DIHS) are severe cutaneous adverse reactions that can be life threatening and leave sequelae. To confirm the medical history of SJS, TEN, and DIHS, three types of data were used for SJS and TEN: the results of nationwide epidemiological surveys, previously published analysis results of individual clinical survey records, and medical claims data. For DIHS, two types of data were used: nationwide surveys and medical claims data. The clinical epidemiology of SJS, TEN, and DIHS has been investigated using nationwide surveys and individual clinical survey data. In this study, we added medical insurance claim information to complement each other's strengths and gain an overall understanding of the disease.

Academic Significance and Societal Importance of the Research Achievements

重症薬疹の臨床疫学像はこれまで全国調査や臨床調査個人票データで検討されていたが、レセプト情報も加えて検討した。レセプトデータは過去の病歴や投薬歴について長期間遡って詳細な情報を検討できる可能性があるが、診断基準や重症度の確認が難しい。診断基準と重症度は全国調査や臨床調査個人票データでは確認可能である。各データの利点を相補完しつつ全体像を把握していくことが求められる。

Research Products

• [Journal Article] Recent Advances in Clinical Research on Rare Intractable Hereditary Skin Diseases in Japan (2025)
  • Author(s): Akiyama Masashi、Takeichi Takuya、Ikeda Shigaku、Ishiko Akira、Kurosawa Michiko、Murota Hiroyuki、Shimomura Yutaka、Suzuki Tamio、Tamai Katsuto、Tanaka Akio、Terui Tadashi、Amagai Masayuki
  • Journal Title: The Keio Journal of Medicine Volume: 74 Issue: 1 Pages: 11-20
  • DOI: 10.2302/kjm.2023-0008-IR
  • ISSN: 0022-9717, 1880-1293
  • Peer Reviewed / Open Access
• [Journal Article] Development and Validation of a Novel Score to Predict Mortality in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: CRISTEN. (2023)
  • Author(s): Hama N, Sunaga Y, French LE, Chen WT, Chung WH, Chu CY, Abe R. et al
  • Journal Title: J Allergy Clin Immunol Pract. Volume: 11（10） Issue: 10 Pages: 3161-3168
  • DOI: 10.1016/j.jaip.2023.07.001
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Risk factors for sepsis and effects of pretreatment with systemic steroid therapy for underlying condition in SJS/TEN patients: Results of a nationwide cross-sectional survey in 489 Japanese patients. (2022)
  • Author(s): Sunaga Y, Hama N, Ochiai H, Kokaze A, Lee ES, Watanabe H, Kurosawa M, Azukizawa H, Asada H, Watanabe Y, Yamaguchi Y, Aihara M, Mizukawa Y, Ohyamag M, Abe R, Hashizume H, Nakajima S, Nomurai T, Kabashima K, Tohyama M, Takahashi H, Mieno H, Ueta M, Sotozono C, Niiharam H, Morita E, Sueki H.
  • Journal Title: J Dermatol Sci. Volume: 107(2) Issue: 2 Pages: 75-81
  • DOI: 10.1016/j.jdermsci.2022.07.004
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Changes in the proportion of clinical clusters contribute to the phenotypic evolution of Behcet's disease in Japan. (2021)
  • Author(s): Soejima Y, Kirino Y, Mitsuhiro Takeno M, Kurosawa M, Masaki Takeuchi M, Ryusuke Yoshimi R, Sugiyama Y, Ohno S, Yukiko Asami Y, Akiko Sekiguchi A, Igarashi T, Nagaoka S, Yoshiaki Ishigatsubo Y, Hideaki Nakajima H, Mizuki N.
  • Journal Title: Arthritis Res Ther. Volume: 23(1) Issue: 1 Pages: 49-49
  • DOI: 10.1186/s13075-020-02406-6
  • Peer Reviewed / Open Access
• [Journal Article] The nationwide epidemiological survey of Stevens-Johnson syndrome and toxic epidermal necrolysis in Japan, 2016-2018. (2020)
  • Author(s): Sunaga Y, Kurosawa M, Ochiai H, Watanabe H, Sueki H, Azukizawa H, Asada H, Watanabe Y, Yamaguchi Y, Aihara M, Mizukawa Y, Ohyama M, Hama N, Abe R, Hashizume H, Nakajima S, Nomura T, Kabashima K, Tohyama M, Takahashi H, Mieno H, Ueta M, Sotozono C, Niihara H, Morita E, Kokaze A.
  • Journal Title: J Dermatol Sci. Volume: 100(3) Issue: 3 Pages: 175-182
  • DOI: 10.1016/j.jdermsci.2020.09.009
  • Peer Reviewed / Open Access
• [Journal Article] Japanese guidelines for the management of pemphigoid (including epidermolysis bullosa acquisita) (2019)
  • Author(s): Ujiie H, Iwata H, Yamagami J, Nakama T, Aoyama Y, Ikeda S, Ishii N, Iwatsuki K, Kurosawa M, Sawamura D8, Tanikawa A, Tsuruta D, Nishie W, Fujimoto W, Amagai M, Shimizu H, Committee for Guidelines for the Management of Pemphigoid Diseases (Including Epidermolysis Bullosa Acquisita)
  • Journal Title: The Journal of Dermatology Volume: 46(12) Issue: 12 Pages: 1102-1135
  • DOI: 10.1111/1346-8138.15111
  • Peer Reviewed / Open Access
• [Journal Article] Results of a nationwide epidemiologic survey of autosomal recessive congenital ichthyosis and ichthyosis syndromes in Japan. (2018)
  • Author(s): Kurosawa M, Uehara R, Takagi A, Aoyama Y, Iwatsuki K, Amagai M, Nagai M, Nakamura Y, Inaba Y, Yokoyama K, Ikeda S.
  • Journal Title: The Journal of the American Academy of Dermatology Volume: in press Issue: 5 Pages: 1086-1092
  • DOI: 10.1016/j.jaad.2018.07.056
  • Peer Reviewed / Open Access
• [Journal Article] Shunt intervention for possible idiopathic normal pressure hydrocephalus improves patient outcomes: a nationwide hospital-based survey in Japan. (2018)
  • Author(s): Nakajima M, Miyajima M, Ogino I, Akiba C, Kawamura K, Kurosawa M, Kuriyama N, Watanabe Y, Fukushima W, Mori E, Kato T, Sugano H, Karagiozov K, Arai H
  • Journal Title: Frontiers in Neurology Volume: 9 Pages: 421-421
  • DOI: 10.3389/fneur.2018.00421
  • Peer Reviewed / Open Access
• [Presentation] 4-ヒドロキシ安息香酸エステル（paraben類）暴露長期毒性評価：allergy衛生仮説考察 (2023)
  • Author(s): 武藤剛, 石橋桜子, 横山和仁, 遠藤源樹, 黒沢美智子, 大森由紀, 弘田量二, 中村裕之
  • Organizer: 第93回日本衛生学会学術総会
• [Presentation] Dramatic decrease of ocular sequelae in Stevens-Johnson syndrome/toxic epidermal necrolysis cases due to early treatment. (2022)
  • Author(s): Nakata M, Fujikawa K, Morita E, Kurosawa M, Sueki H, Asada H, Kinoshita S, Sotozono C
  • Organizer: American Academy of Ophthalmology (AAO) Annual Meeting 2022
  • Int'l Joint Research
• [Presentation] 第2回Stevens-Johnson症候群ならびに中毒性表皮壊死症の全国疫学調査. (2020)
  • Author(s): 須長由真, 落合裕隆, 小風暁, 黒沢美智子, 森田栄伸, 末木博彦:
  • Organizer: 第119回日本皮膚科学会総会
• [Presentation] びまん性大細胞型B細胞リンパ腫の経過中にStevens-Johnson症候群を発症した1例 (2020)
  • Author(s): 本澤頌太, 梶野一徳, 佐伯春美, 黒澤美智子, 枝廣陽子, 木下慎太郎, 高久智生, ワリナディラ, 大辻奈穂美, 樋野興夫:
  • Organizer: 第109回日本病理学会総会
• [Presentation] Stevens-Johnson症候群と中毒性表皮壊死症の患者数推計: 全国疫学調査より (2020)
  • Author(s): 黒沢美智子, 末木博彦, 須長由真, 森田栄伸, 小風暁, 新原寛之, 相原道子, 浅田秀夫, 阿部理一郎, 橋爪秀夫, 椛島健治, 大山学, 高橋勇人, 藤山幹子, 外園千恵, 渡辺秀晃, 中村好一
  • Organizer: 第30回日本疫学会学術総会
• [Presentation] Subgroup classification of Behçet's disease using clinical information: analysis of a clinical database of patients receiving financial aid for treatment. (2018)
  • Author(s): Kurosawa M, Takeno M, Kirino Y, Soejima Y, Mizuki N
  • Organizer: 18th International Conference on Behçet's Disease
  • Int'l Joint Research