Stevens-Johnson syndrome and toxic epidermal necrolysis

Background

• SJS and TEN involve IC-mediated cell death w/ separation of epidermis from dermis
  • SJS involves <10% of BSA
  • TEN involves >30% of BSA

Diagnosis

• Often have prodrome (fever, URI symptoms, HA, malaise)
• Rash begins suddenly, mucus membranes are severely affected
  • Target lesion
  • Eye involvement can be severe
  • In severe cases, respiratory tract and GI involvement may occur

Treatment

• Removal of inciting cause if identified
• Treat shock w/ IV fluids according to burn protocols

Disposition

• Admit to burn unit or ICU

Source

Tintinalli