dermatologic disorders
Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)
Key Points
Drugs cause > 50% of Stevens-Johnson syndrome (SJS) and up to 95% of toxic epidermal necrolysis (TEN) cases, but infection, vaccination, and graft-vs-host disease are also potential causes. Confirm the diagnosis by biopsy (showing necrotic epithelium) if clinical characteristics (eg, target lesions progressing to bullae, ocular and mucous membrane involvement, Nikolsky sign, desquamation in sheets) are inconclusive. Early treatment decreases the often high mortality rate. Except for mild cases, treat SJS/TEN in a burn unit and with intensive supportive care. Consult ophthalmology if the eyes are affected. Considercyclosporineand possibly plasmapheresis for severe cases. 