Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis
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Introduction
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but severe mucocutaneous reactions characterized by widespread epidermal necrolysis and sloughing. By convention, SJS denotes <10% involvement of body surface area (BSA), >30% is designated as TEN, and 10%-30% is SJS/TEN overlap. These conditions are considered dermatologic emergencies because they result in high morbidity and mortality rates (~25%).
Etiology and risk factors
SJS/TEN is caused by the following:
- Medications (~80% of cases): A wide range of medications have been implicated; these include antibiotics (eg, sulfa drugs, penicillins, cephalosporins), antiepileptic drugs (eg, phenytoin, carbamazepine), nonsteroidal anti-inflammatory drugs, and allopurinol. Symptoms typically occur within a month of starting the offending medication.
- Infections: Mycoplasma pneumoniae and herpes simplex virus (HSV) are commonly implicated infections.
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