Identifying SJS/TEN using ICD-9-CM coding - Real or just fantasy?

• Published in: Allergology International 2020-01, Vol.69 (1), p.136-137
• Main Authors: Leonor Carneiro-Leao, Maria Joao Vasconcelos, Josefina Cernadas
• Format: Article
• Language: Japanese
• ISSN: 1323-8930

Dear Editor, Steven-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe cutaneous adverse reactions (SCAR), characterized by the appearance of a blistering, detaching, painful skin eruption, mucosal involvement, multiorgan abnormalities, fever and malaise. Nowadays, SJS and TEN are considered to be a continuum of the same disease and the percentage of skin detachment defines the final diagnosis. They are usually caused by drugs, being a T-cell mediated, delayed type hypersensitivity reaction. Rarely, it can also be caused by exposure to herbal preparations or infections. TEN presents the worst prognosis of all SCAR, with mortality rates up to 50%. Due to some clinical resemblance, there was a widespread belief that SJS/TEN were related to erythema multiform major (EMM), with the later being considered a milder form of the spectrum. This concept has now been largely abandoned and the distinction between EMM and SJS/TEN is crucial, considering SJS/TEN's poorer prognosis, different etiopathogenesis, treatment and follow-up strategies. International Classification of Disease, 9th edition, Clinical Modification (ICD-9-CM) is a dynamic statistical tool, used to report diagnoses and services on healthcare claims.