Introduction: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe mucocutaneous adverse drug reactions, in which leukocytes and immune cells play a central role in the pathogenesis. However, the changes of peripheral blood leukocyte counts in these patients remain unclear. Our objective was to evaluate leukocyte count fluctuations and their clinical correlations in patients with SJS/TEN. Methods: We conducted a case series on patients diagnosed with SJS/TEN from October 2017 to September 2019. Serum levels of tumour necrosis factor alpha (TNF-α) and interferon gamma (IFN-γ) were measured at hospital admission and during the re-epithelialization phase. Clinical characteristics and complete blood count results were recorded. Results: Our study included 26 patients diagnosed with SJS/TEN (9 with SJS and 17 with TEN). The common changes of leukocyte counts in our SJS/TEN patients showed a decrease between days 4 and 7 after symptom onset, followed by a marked increase, often exceeding the upper reference limit (10 × 10 9 /L). Most patients exhibited a rise in leukocyte counts during the re-epithelialization phase, accompanied by a decrease in serum levels of TNF-α and IFN-γ ( P = 0.118 and P < 0.001, respectively). Conclusion: In our SJS/TEN patients, peripheral blood leukocyte counts initially decrease during the early phase and subsequently increase during re-epithelialization. This leukocytosis appears to be associated with the skin healing process.
Trần et al. (Tue,) studied this question.