Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)

Dr Swapnil Pawar July 26, 2022 35

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)
Dr Swapnil Pawar

SJS/TEN Shownotes

Written by Dr Andrew Lam

SJS – Skin detachment affecting <10% of body surface area

TEN – Skin detachment affecting >30% of body surface area

SJS/TEN Overlap Syndrome – Skin detachment affecting 10-30% of body surface area

SJS/TEN vs. DRESS vs. AGEP

	SJS/TEN	DRESS	AGEP
Time till Onset of Rash	1-3 Weeks	2-6 Weeks	48 Hours
Cutaneous Features	Confluent macular erythema, bullae, mucocutaneous features	Facial oedema, morbiliform eruption, exfoliative dermatitis	Pinpoint pustules with underlying erythematous base
Histological Features	Epidermal Necrosis	Perivascular lymphocytosis	Subcorneal pustules
Mortality	5-35%	10%	5%

Causes of SJS

Drugs

Allopurinol
Sulfonamide antibiotics
Anti-epileptics
NSAID’s

Infection

Mycoplasma Pneumonia (particularly in children)

Idiopathic

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