Steven-Johnson Syndrome/Toxic Epidermal necrolysis (SJS/TEN) is a life threatening exfoliative mucocutaneous disease. It often caused by a drug induce immunologic reaction such as sulfa drugs, carbamazepine, phenytoin, valproic acid, quinolones, cephalosporins, phenobarbital, allopurinol, aminopenicillins, and corticosteroids.
Signs and Symptoms:
- History of new drug exposure within 1-3 weeks
- Flu-like prodrome
- Skin tenderness
- Painful mouth lesions
- Nikolsky's sign is positive
- Coalescing red macules and flaccid blisters with full-thickness epidermal loss
- Sepsis from superimposed bacterial skin infections that leads to death
- Eliminate the offending agents
- Analgesia and IVIG
- Hospitalize in the burn center to manage skin and fluid losses
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