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Stevens-Johnson syndrome and toxic epidermal necrolysis: Pathogenesis, clinical manifestations, and diagnosis

Authors
Whitney A High, MD
Jean-Claude Roujeau, MD
Section Editors
N Franklin Adkinson, Jr, MD
Moise L Levy, MD
Maja Mockenhaupt, MD, PhD
Deputy Editor
Rosamaria Corona, MD, DSc

INTRODUCTION AND TERMINOLOGY

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe mucocutaneous reactions, most commonly triggered by medications, characterized by extensive necrosis and detachment of the epidermis [1]. According to a widely accepted classification, SJS and TEN are considered a disease continuum and are distinguished chiefly by severity, based upon the percentage of body surface involved with blisters and erosions (table 1) [2,3]:

SJS is the less severe condition, in which skin detachment is <10 percent of the body surface (picture 1A-C). Mucous membranes are affected in over 90 percent of patients, usually at two or more distinct sites (ocular, oral, and genital).

TEN involves detachment of >30 percent of the body surface area (BSA) (picture 2A-D). Mucous membranes are also involved in over 90 percent of patients.

SJS/TEN overlap describes patients with skin detachment of 10 to 30 percent of BSA.

We will use the term "SJS/TEN" to refer collectively to SJS, TEN, and SJS/TEN overlap syndrome.

                                             
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Literature review current through: Nov 2017. | This topic last updated: Nov 15, 2017.
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