Stevens-Johnson syndrome and toxic epidermal necrolysis

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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

Work-Up

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