SJS/TEN - Drug Eruptions

 • Time Course: 4-21 days

 • Rash: Prodromal fevers, malaise, myalgias/arthralgias. Pruritic atypical targetoid (amorphous, 2 color zones) macules → bullae → desquamation 

   <10% BSA = SJS

   10-30% BSA = SJS/TEN overlap

   >30% BSA= TEN

 • Other Signs/Sx: Mucosal bullae, erosions & crusting, conjunctivitis + Nikolsky sign 

 • Complications: 2° infection, resp. compromise, GIB, visual impairment

 • Common Drugs: Abx (sulfa), AEDs, NSAIDs, allopurinol, phenobarbital

 • Treatment:	

    - Cyclosporine 

    - Steroids possible mortality benefit but controversial 

    - IVIG, anti-TNF 

    - Burn level care if >30% BSA



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