ALDEN

Q: ALDEN is an algorithm to determine the causality of which disease?

Answer: Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) 

The most likely etiology of SJS/TEN cases is due to few high-risk medications, usually divided into three categories:

1. Strongly associated
2. Associated
3. Suspected association/lower risk

ALDEN stands for 'algorithm of drug causality for epidermal necrolysis'. It is used to determine the offending drug.

The Six-Point Algorithm is available via any search engine. The likelihood of a patient having SJS/TEN is based on the final score:

Score <0 — Very unlikely

Score 0 to 1 — Unlikely

Score 2 to 3 — Possible

Score 4 to 5 — Probable

Score ≥6 — Very probable

#dermatology

#toxicity

         

         

References:

         

1. Clinical Pharmacology and Therapeutics. Sassolas B, Haddad C, Mockenhaupt M, et al. ALDEN, an algorithm for assessment of drug causality in Stevens-Johnson syndrome and toxic epidermal necrolysis: comparison with case-control analysis. Clin Pharmacol Ther 2010; 88:60. www.nature.com/cpt. Copyright © 2010.

         

         

2. Roujeau JC, Kelly JP, Naldi L, et al. Medication use and the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis. N Engl J Med 1995; 333:1600.

3. The RegiSCAR Project. Available at: http://www.regiscar.org/index.html (Accessed on May 4, 2025).