BACKGROUND:The relative risks of HBV reactivation (HBVr) and HCV reactivation (HCVr) associated with different immunosuppressant agents in psoriasis and psoriatic arthritis are unknown. OBJECTIVE:We assessed the comparative risks of HBVr and HCVr for patients treated with biologics and targeted synthetic disease-modifying antirheumatic drugs. METHODS:We screened 5,527 treatment episodes (TEs) with available HBV and HCV serology data from 3197 patients who received biologics or targeted synthetic disease-modifying antirheumatic drugs; 1525 eligible TEs (1343 HBV TEs; 182 HCV TEs) were included. RESULTS:HBVr and HCVr occurred in 143 (10.6%) and 18 (9.9%) of TEs during 2104.5 and 271.2 person-years of follow-up, respectively. The risks of HBVr and HCVr were highest for tumor necrosis factor-α inhibitors, followed by interleukin-12/23 inhibitor (IL-12/23i), IL-17i, and IL-23i. Analysis revealed drug class (tumor necrosis factor-α inhibitors), hepatitis B surface antigen-positivity, hepatitis B e-antigen-positivity, concomitant use of immunosuppressants, and absence of antiviral prophylaxis were significantly associated with HBVr; a higher baseline viral load and drug class (tumor necrosis factor-α inhibitors) were associated with HCVr. LIMITATIONS:Observational design and nonrandom treatment allocation. CONCLUSIONS:The differential risks of HBVr and HCVr should be considered when selecting targeted therapies in psoriasis and psoriatic arthritis, particularly for patients with risk factors for viral reactivation.

Han Chinese people comprise nearly 20% of the global population but remain under-represented in genetic studies1,2, so there is an urgent need for large-scale cohorts to advance precision medicine. Here we present the Taiwan Precision Medicine Initiative (TPMI), established by Academia Sinica in collaboration with 16 major medical centres around Taiwan, which has recruited 565,390 participants who consent to provide DNA samples for genetic profiling and grant access to their electronic medical records (EMRs) for research. EMR access is both retrospective and prospective, allowing longitudinal studies. Genetic profiling is done with population-optimized arrays of single-nucleotide polymorphisms for people of Han Chinese ancestry, which enable genome-wide association3,4, phenome-wide association5,6 and polygenic risk score7,8 studies to be performed to evaluate common disease risk and pharmacogenetic response. Participants also agreed to be re-contacted for future research and receive personalized genetic risk profiles with health management recommendations. The TPMI has established the TPMI Data Access Platform, a central database and analysis platform that both safeguards the security of the data and facilitates academic research. As a large cohort of individuals with non-European ancestry that merges genetic profiles with EMR data and enables longitudinal follow-up, TPMI provides a unique resource that could be used to validate genetic risk prediction models, perform clinical trials of risk-based health management and inform health policies. Ultimately, the TPMI cohort will contribute to global genetic research and serve as a model for population-based precision medicine.

Chronic inflammatory skin diseases (CISD) are characterized by immune activation and dysregulation ( Eyerich and Eyerich, 2018 Eyerich K. Eyerich S. Immune response patterns in non-communicable inflammatory skin diseases. J Eur Acad Dermatol Venereol. 2018; 32: 692-703 Crossref PubMed Scopus (103) Google Scholar ). The mechanisms that lead to CISD remain to be elucidated. Various factors including genetic and environmental factors, such as drug exposure, may be involved in the development of CISD ( Chiu et al., 2018 Chiu H.Y. Chang W.L. Tsai T.F. Tsai Y.W. Shiu M.N. Risk of Psoriasis Following Terbinafine or Itraconazole Treatment for Onychomycosis: A Population-Based Case-Control Comparative Study. Drug Saf. 2018; 41: 285-295 Crossref PubMed Scopus (7) Google Scholar , Ghaedi et al., 2021 Ghaedi F. Etesami I. Aryanian Z. Kalantari Y. Goodarzi A. Teymourpour A. et al. Drug-induced pemphigus: A systematic review of 170 patients. Int Immunopharmacol. 2021; 92107299 Crossref PubMed Scopus (24) Google Scholar , Milavec-Puretic et al., 2011 Milavec-Puretic V. Mance M. Ceovic R. Lipozencic J. Drug induced psoriasis. Acta Dermatovenerol Croat. 2011; 19: 39-42 PubMed Google Scholar , Murad et al., 2021 Murad A. Maguire J. Bergfeld W. Drug-induced alopecia areata?. Clin Exp Dermatol. 2021; 46: 363-366 Crossref PubMed Scopus (9) Google Scholar ).

The comparative efficacy of biologics and small-molecule inhibitors in treating palmoplantar psoriasis (PP) and palmoplantar pustulosis (PPP) remains uncertain. The aim was to perform a systematic review and network meta-analysis (NMA) to compare the efficacy of biologics and small-molecule inhibitors for the treatment of PP and PPP. MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were searched for eligible studies from inception to May 13, 2023. This NMA was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension Statement for Network Meta-Analyses guidelines. Frequentist random-effects models NMA was performed with the surface under the cumulative ranking curve calculated for ranking. Our primary outcome was the proportion of patients achieving a clear/minimal Palmoplantar Psoriasis/Pustulosis Physician Global Assessment score (PPPGA 0/1 or PPPPGA 0/1) response at 12–16 weeks. Secondary outcomes consisted of the percentage of overall improvement in palmoplantar score and of improvement ≥ 75

The Taiwan Precision Medicine Initiative (TPMI), a project initiated by the Academia Sinica in collaboration with 16 major medical centers around Taiwan, has recruited 565,390 participants who consented to provide DNA samples for genetic profiling and grant access to their electronic medical records (EMR) for studies to develop precision medicine. Access to the EMR is both retrospective and prospective, allowing researchers to conduct prospective studies over time. Genetic profiling is done with population-optimized SNP arrays for the Han Chinese populations that enable genetic analyses such as genome-wide association, phenome-wide association, and polygenic risk score studies to evaluate common disease risk and pharmacogenetic response. Furthermore, the TPMI participants agree to be contacted for future research opportunities related to their genetic risks and receive personalized genetic risk profiles with health management recommendations. TPMI has established the TPMI Data Access Platform (TDAP), a central database and analysis platform that both safeguards the security of the data and facilitates academic research. The TPMI is the largest non-European cohort that merges genetic profiles with EMR in the world. With a cohort that can be followed over time, it can be utilized to validate genetic risk prediction models, conduct clinical trials to show the efficacy of risk-based health management, and optimize health policies based on genetic risks. In this report, we describe the TPMI study design, the population and genetic characteristics of the TPMI cohort, and the power it provides to conduct crucial studies in developing precision medicine on a population and personal level. As Han Chinese represent almost 20% of the world's population, the results of TPMI studies will benefit >1.4 billion people around the world and serve as a model for developing population-based precision medicine. ### Competing Interest Statement The authors have declared no competing interest.

For patients with psoriasis, discontinuation of biologics following remission has become more common in daily practice. We aimed to identify predictors and construct a predictive model for time to relapse following withdrawal from biologics. This 12-year, multicenter, observational cohort study was performed in six dermatology centers between February 2011 and February 2024. We identified biological treatment episodes in patients with moderate-to-severe psoriasis and included only treatment episodes in which a clinical response (≥ 50

Skin metabolites show huge potential for use in clinical diagnostics. However, skin sampling and analysis workflows are tedious and time-consuming. Here, we demonstrate a vending-machine-style skin excretion sensing platform based on hydrogel-assisted sampling of skin metabolites. In this sensing platform, a sampling probe with hydrogel is held by a robotic arm. The robotic arm manoeuvres the probe to press it onto the forearm of a human subject. Due to the highly hydrophilic nature of the hydrogel, water-soluble metabolites─released by skin─are collected into the hydrogel, leaving behind the nonpolar metabolites. The probe is then inserted into a custom-made open port sampling interface coupled to an electrospray ion source of a high-resolution quadrupole-time-of-flight mass spectrometer. Metabolites in the hydrogel are immediately extracted by a solvent liquid junction in the interface and analyzed using the mass spectrometer. The ion current of the target analyte is displayed on a customized graphical user interface, which can also be used to control the key components of the analytical platform. The automated sampling and analysis workflow starts after the user inserts coins or presents an insurance card, presses a button, and extends an arm on the sampling area. The platform relies on low-cost mechanical and electronic modules (a robotic arm, a single-board computer, and two microcontroller boards). The limits of detection for standard analytes─arginine, citrulline, and histidine─embedded in agarose gel beds were 148, 205, and 199 nM, respectively. Various low-molecular-weight metabolites from human skin have been identified with the high-resolution mass spectrometer.

Herpes zoster (HZ), which is reactivation of the varicella zoster virus (VZV), is associated with older age, use of immunomodulatory drugs, trauma, family history, and other comorbidities.1Rodríguez-Jiménez P. Chicharro P. Cabrera L.M. et al.Varicella-zoster virus reactivation after SARS-CoV-2 BNT162b2 mRNA vaccination: report of 5 cases.JAAD Case Rep. 2021; 12: 58-59Abstract Full Text Full Text PDF PubMed Scopus (80) Google Scholar Moreover, case studies have reported development of HZ following administration of vaccinations against influenza, Japanese encephalitis, hepatitis A, and rabies.2Walter R. Hartmann K. Fleisch F. Reinhart W.H. Kuhn M. Reactivation of herpesvirus infections after vaccinations?.Lancet. 1999; 353: 810Abstract Full Text Full Text PDF PubMed Scopus (73) Google Scholar Recently, several cases of HZ after COVID-19 vaccinations have been reported1Rodríguez-Jiménez P. Chicharro P. Cabrera L.M. et al.Varicella-zoster virus reactivation after SARS-CoV-2 BNT162b2 mRNA vaccination: report of 5 cases.JAAD Case Rep. 2021; 12: 58-59Abstract Full Text Full Text PDF PubMed Scopus (80) Google Scholar; however, the association remains a matter of debate due to the small number of cases and lack of control groups. We performed a systematic search within PubMed, EMBASE, and Web of Science for relevant publications from inception to November 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The protocol was registered in PROSPERO (CRD42023381589). Cohort studies, case-control cross-sectional studies, and randomized controlled trials reporting HZ outcomes in patients receiving COVID-19 vaccinations and control subjects were included. Studies with overlapping cases, lack of HZ outcomes, incomplete data, and case studies without controls were excluded (Supplementary Fig 1, available via Mendeley at https://data.mendeley.com/datasets/6jg7jkn65r/1). This meta-analysis (MA) used a random-effects model to calculate the pooled odds ratios (ORs) and 95% CIs to determine the risk of HZ in the COVID-19 vaccination group versus control groups. Subgroup analyses comparing the risk of HZ in the mRNA versus adenovirus vaccination groups and Moderna versus BioNTech vaccination groups were performed. Sixteen studies were included from initially identified 465 articles (Supplementary Table I, available via Mendeley at https://data.mendeley.com/datasets/6jg7jkn65r/1). COVID-19 vaccination was associated with a significantly increased risk of HZ (OR, 1.32; 95% CI, 1.09-1.62, P = .006) compared with controls (Supplementary Fig 2, available via Mendeley at https://data.mendeley.com/datasets/6jg7jkn65r/1). In subgroup analysis, the mRNA vaccination was associated with a higher risk of HZ compared with the adenovirus vaccination (OR, 1.67; 95% CI, 1.19-2.35, P = .003) (Supplementary Fig 3, available via Mendeley at https://data.mendeley.com/datasets/6jg7jkn65r/1). Further MA of studies comparing different brands of COVID-19 vaccinations showed no significant difference of HZ risks between Moderna and BioNTech (OR, 0.64; 95% CI, 0.18-2.21) (Supplementary Fig 4, available via Mendeley at https://data.mendeley.com/datasets/6jg7jkn65r/1). The mechanism underlying the link between COVID-19 vaccination and HZ remains elusive; however, vaccination-induced immunomodulation has been proposed. Vaccine-induced massive shift of CD8+ T cells and CD4+ helper T cells may cause temporary inability to suppress latent VZV, allowing for its reactivation.3Psichogiou M. Samarkos M. Mikos N. Hatzakis A. Reactivation of varicella zoster virus after vaccination for SARS-CoV-2.Vaccines (Basel). 2021; 9: 572Crossref PubMed Scopus (76) Google Scholar Previous studies indicate that immunocompromised status and older age are associated with a higher risk of VZV reactivations after vaccination.4Préta L.H. Contejean A. Salvo F. Treluyer J.M. Charlier C. Chouchana L. Association study between herpes zoster reporting and mRNA COVID-19 vaccines (BNT162b2 and mRNA-1273).Br J Clin Pharmacol. 2022; 88: 3529-3534Crossref PubMed Scopus (15) Google Scholar The reported median time to onset of HZ after COVID-19 vaccination was 7 to 10 days (range, 2-51 days).1Rodríguez-Jiménez P. Chicharro P. Cabrera L.M. et al.Varicella-zoster virus reactivation after SARS-CoV-2 BNT162b2 mRNA vaccination: report of 5 cases.JAAD Case Rep. 2021; 12: 58-59Abstract Full Text Full Text PDF PubMed Scopus (80) Google Scholar,4Préta L.H. Contejean A. Salvo F. Treluyer J.M. Charlier C. Chouchana L. Association study between herpes zoster reporting and mRNA COVID-19 vaccines (BNT162b2 and mRNA-1273).Br J Clin Pharmacol. 2022; 88: 3529-3534Crossref PubMed Scopus (15) Google Scholar,5Said J.T. Virgen C.A. Lian C.G. Cutler C.S. Merola J.F. LeBoeuf N.R. Disseminated varicella-zoster virus infections following messenger RNA-based COVID-19 vaccination.JAAD Case Rep. 2021; 17: 126-129Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar Although most cases of VZV reactivations were dermatome-limited, 2 cases of HZ infection after COVID-19 mRNA vaccination were disseminated.5Said J.T. Virgen C.A. Lian C.G. Cutler C.S. Merola J.F. LeBoeuf N.R. Disseminated varicella-zoster virus infections following messenger RNA-based COVID-19 vaccination.JAAD Case Rep. 2021; 17: 126-129Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar Our research has limitations. First, because most randomized controlled trials of COVID-19 vaccination did not report HZ as a separate individual adverse effect, the number of randomized controlled trials included in this MA is quite limited. Second, heterogeneity exists among the included studies, and the quality of the included studies is not very high (Supplementary Fig 5, available via Mendeley at https://data.mendeley.com/datasets/6jg7jkn65r/1). Nevertheless, our MA suggests an increased risk of HZ in patients receiving COVID-19 vaccination, and the mRNA vaccination is associated with a higher risk of HZ than the adenovirus vaccination. This highlights the awareness of possible reactivation of HZ following COVID-19 vaccination, particularly for high-risk individuals. H.Y.C. received speaking fees from AbbVie, Novartis Pharmaceuticals Corporation, Janssen-Cilag Pharmaceutica, Eli-Lilly, Kyowa Hakko Kirin Taiwan, and Pfizer Limited and conducted clinical trials for Eli-Lilly, AbbVie, and Sanofi Pharmaceuticals. I.L.C. has no conflicts of interest to declare. We thank the staff of Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch for their assistance in study design, statistical analysis, and providing careful review and insightful comments regarding the articles.

Background: Patients with psoriasis have a significant disease burden throughout the life course. Nevertheless, the lifetime risk and disease burden of psoriasis across the entire lifespan is rarely quantified in an easily understandable way. Objective: To estimate the cumulative incidence rate, life expectancy, loss-of-life expectancy, and lifetime healthcare expenditures for incident psoriasis. Design and methods: Using real-world nationwide data from the National Health Insurance Research Database of Taiwan for 2000–2017, along with the life tables of vital statistics, we estimated cumulative incidence rate, life expectancy, loss-of-life expectancy, and lifetime healthcare expenditures for those with psoriasis using a semi-parametric survival extrapolation method. Results: A total of 217,924 new psoriasis cases were identified. The lifetime risk of psoriasis in patients aged 18–80 for both sexes decreased in Taiwan with a cumulative incidence rate of 7.93% in 2000 to 3.25% in 2017. The mean (±standard error) life expectancy after diagnosis was 27.11 (± 1.15) and 27.14 (±1.17) years for patients with moderate-to-severe psoriasis and psoriatic arthritis, respectively. Patients with moderate-to-severe psoriasis and psoriatic arthritis had a mean (±standard error) loss-of-life expectancy of 6.41 (±1.16) and 6.48 (±1.17) due to psoriasis, respectively. Male patients have higher lifetime and annual lifetime healthcare expenditures than female. Mean life expectancy, loss-of-life expectancy, and lifetime cost were relatively higher for younger patients. Conclusion: Among psoriatic patients, patients with moderate-to-severe psoriasis and psoriatic arthritis had substantial years of life lost, particularly for younger patients. Our results provide a reliable estimation of lifetime disease burden, and these estimates will help health authorities in cost-effectiveness assessments of public health interventions and allocation of services resources to minimize loss-of-life expectancy, and lifetime healthcare expenditures in patients with psoriasis.

A facile and rapid skin metabolomics protocol is proposed. The liquid microjunction-surface sampling probe system has been partly automated, and used in conjunction with hydrogel probes for skin metabolite analysis. A control device was built to precisely control the segmented solvent flow and analyte re-extraction into the liquid microjunction. This mode provides rapid online re-extraction of the analytes from hydrogel probes. Humectant was added to the hydrogel, and moist heat treatment was used to make the hydrogel probes rugged for sampling in the clinical setting. The developed method was validated for the analysis of choline - a putative biomarker of psoriasis. A linear relationship over six calibration levels from 3.18 × 10-5 to 3.18 × 10-4 mol m-2 has been obtained. The limit of detection was 6.6 × 10-6 mol m-2, while the recoveries range from 92 to 109%. The within-run and between-run precision were evaluated and the coefficients of variation range from 1.84 to 7.13%. Furthermore, the developed method has been used to screen patients (n = 10) and healthy participants (control group; n = 10) for psoriasis-related skin metabolites. Metabolomic profiling of the skin excretion-related signals identified potential biomarkers of psoriasis: choline, pipecolic acid, ornithine, urocanic acid, and methionine.

Psoriatic disease is a chronic inflammatory disorder with skin and joint manifestations. Due to the persistent inflammatory state exhibited by patients with psoriasis, multiple systemic comorbidities occur more frequently in patients with psoriasis than in the general population, and the risk of cardiovascular (CV) diseases is significantly increased. As the pathophysiology of psoriatic disease is becoming better understood, the sharing of underlying pathogenic mechanisms between psoriatic and CV diseases is becoming increasingly apparent. Consequently, careful attention to CV comorbidities that already exist or may potentially develop is needed in the management of patients with psoriasis, particularly in the screening and primary prevention of CV disease and in treatment selection due to potential drug-drug and drug-disease interactions. Furthermore, as the use of effective biologic therapy and more aggressive oral systemic treatment for psoriatic disease is increasing, consideration of the potential positive and negative effects of oral and biologic treatment on CV disease is warranted. To improve outcomes and quality of care for patients with psoriasis, the Taiwanese Dermatological Association, the Taiwanese Association for Psoriasis and Skin Immunology, and the Taiwan Society of Cardiology established a Task Force of 20 clinicians from the fields of dermatology, cardiology, and rheumatology to jointly develop consensus expert recommendations for the management of patients with psoriatic disease with attention to CV comorbidities.

Human skin emits a unique set of volatile organic compounds (VOCs). These VOCs can be probed in order to obtain physiological information about the individuals. However, extracting the VOCs that emanate from human skin for analysis is troublesome and time-consuming. Therefore, we have developed "Mass Specthoscope"─a convenient tool for rapid sampling and detecting VOCs emitted by human skin. The hand-held probe with a pressurized tip and wireless button enables sampling VOCs from surfaces and their transfer to the atmospheric pressure chemical ionization source of quadrupole time-of-flight mass spectrometer. The system was characterized using chemical standards (acetone, benzaldehyde, sulcatone, α-pinene, and decanal). The limits of detection are in the range from 2.25 × 10-5 to 3.79 × 10-5 mol m-2. The system was initially tested by detecting VOCs emanating from porcine skin spiked with VOCs as well as unspiked fresh and spoiled ham. In the main test, the skin of nine healthy participants was probed with the Mass Specthoscope. The sampling regions included the armpit, forearm, and forehead. Numerous skin-related VOC signals were detected. In the final test, one participant ingested a fenugreek drink, and the participant's skin surface was probed using the Mass Specthoscope hourly during the 8 h period. The result revealed a gradual release of fenugreek-related VOCs from the skin. We believe that this analytical approach has the potential to be used in metabolomic studies and following further identification of disease biomarkers─also in noninvasive diagnostics.

Dual-specificity phosphatase 8 (DUSP8) is a MAPK phosphatase that dephosphorylates and inactivates the kinase JNK. DUSP8 is highly expressed in T cells; however, the in vivo role of DUSP8 in T cells remains unclear. Using T cell–specific Dusp8 conditional KO (T-Dusp8 cKO) mice, mass spectrometry analysis, ChIP-Seq, and immune analysis, we found that DUSP8 interacted with Pur-α, stimulated interleukin-9 (IL-9) gene expression, and promoted Th9 differentiation. Mechanistically, DUSP8 dephosphorylated the transcriptional repressor Pur-α upon TGF-β signaling, leading to the nuclear export of Pur-α and subsequent IL-9 transcriptional activation. Furthermore, Il-9 mRNA levels were induced in Pur-α–deficient T cells. In addition, T-Dusp8–cKO mice displayed reduction of IL-9 and Th9-mediated immune responses in the allergic asthma model. Reduction of Il-9 mRNA levels in T cells and allergic responses of T-Dusp8–cKO mice was reversed by Pur-α knockout. Remarkably, DUSP8 protein levels and the DUSP8–Pur-α interaction were indeed increased in the cytoplasm of T cells from people with asthma and patients with atopic dermatitis. Collectively, DUSP8 induces TGF-β–stimulated IL-9 transcription and Th9-induced allergic responses by inhibiting the nuclear translocation of the transcriptional repressor Pur-α. DUSP8 may be a T-cell biomarker and therapeutic target for asthma and atopic dermatitis.

Figure S1. Hair cycles and disruption and restoration of differentiation in anagen HFs after IR. Figure S2. Comparison of apoptosis and DNA damage response of K5+ and K5negative cells in the hair matrix. Figure S3. Immunofluorescent comparison of lower tip cells of the epithelial strand at 72hrs after 5.5Gy of IR with BgSCs and ShgSCs and cell sorting. Figure S4. Lineage tracing of Lgr5+ cells after 5.5Gy of IR. Figure S5. WNT signaling after 2Gy of IR. Figure S6. Histology, apoptosis and cell proliferation in p53 null mice after 2Gy of IR, and the effect of Wnt3a treatment on HF differentiation. Figure S7. Effect of Wnt3a treatment on HFs after 5.5Gy of IR. Table S1. Antibodies used in immunostaining. Table S2. Primer sequences for quantitative RT-PCR. Table S3. Pathways significantly affected in the epithelial cells after 5.5Gy of IR.

Graphene oxide-based materials (GOBMs) have been widely explored as nano-reinforcements in cementitious composites due to their unique properties. Oxygen-containing functional groups in GOBMs are crucial for enhancing the microstructure of cementitious composites. A better comprehension of their surface chemistry and mechanisms is required to advance the potential applications in cementitious composites of functionalized GOBMs. However, the mechanism by which the oxygen-containing functional groups enhance the response of cementitious composites is still unclear, and controlling the surface chemistry of GOBMs is currently constrained. This review aims to investigate the reactions and mechanisms for functionalized GOBMs as additives incorporated in cement composites. A variety of GOBMs, including graphene oxide (GO), hydroxylated graphene (HO-G), edge-carboxylated graphene (ECG), edge-oxidized graphene oxide (EOGO), reduced graphene oxide (rGO), and GO/silane composite, are discussed with regard to their oxygen functional groups and interactions with the cement microstructure. This review provides insight into the potential benefits of using GOBMs as nano-reinforcements in cementitious composites. A better understanding of the surface chemistry and mechanisms of GOBMs will enable the development of more effective functionalization strategies and open up new possibilities for the design of high-performance cementitious composites.

BACKGROUND:Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) not only cause acute, devastating mucocutaneous reactions but also have long-lasting implications on survivors' lives.OBJECTIVES:To quantify the lifetime burden of SJS/TEN.METHODS:The cumulative incidence rate (CIR), life expectancy (LE), loss-of-life expectancy (LoLE) and lifetime healthcare expenditure (HE) for SJS/TEN were estimated over the period from 2008 to 2019 using data from the National Health Insurance Research Database of Taiwan and life tables of vital statistics.RESULTS:In this nationwide cohort of 6552 incident SJS/TEN cases, a trend towards a decrease in the CIR was observed between 2008 and 2019. Compared with the general population, patients with SJS/TEN experience a tremendous loss of 9.43 (1.06) [mean (SEM)] years of LE after diagnosis of SJS/TEN. Male patients with SJS/TEN had higher LoLE [10.74 (1.22) vs. 7.69 (1.43) years] and annual HE than females. Younger age at diagnosis of SJS/TEN was associated with longer LE but greater LoLE and higher lifetime HE. Patients with intensive care unit admission on diagnosis, malignancy, diabetes mellitus, end-stage renal disease and SJS/TEN-associated sequelae experienced substantially greater LoLE and HE per life year.CONCLUSIONS:Patients with SJS/TEN suffer substantial loss-of-LE and HE, particularly young patients, compared with the general population. These data provide a reference estimate of the lifetime burden of SJS/TEN to help health authorities evaluate the cost-effectiveness of future preventive and treatment strategies to minimize the burden of SJS/TEN.