Stevens-Johnson syndrome and toxic epidermal necrolysis
Epidermal necrolysis from culprit drugs and HLA risk to SCORTEN, burns unit care, the eye, mouth and genital care that prevents lifelong damage, ciclosporin and etanercept, distinguishing erythema multiforme and SSSS, and labelling.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Epidermal necrolysis is one disease with three names by area of detachment: SJS under 10% of body surface area, overlap 10 to 30%, TEN over 30%.
- Drugs cause over 80% of adult cases. Allopurinol, aromatic anticonvulsants, sulfonamide antibiotics, nevirapine and oxicam NSAIDs lead the list.
- Mortality is about 10% for SJS and 30% or more for TEN. Score SCORTEN on days 1 and 3.
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Sources
- Therapeutic Guidelines: Dermatology (Stevens-Johnson syndrome and toxic epidermal necrolysis)AU/NZTherapeutic Guidelines Limited (eTG complete), current online edition (topic version not verified)
- ASCIA drug (medication) allergy resources and terminologyAU/NZAustralasian Society of Clinical Immunology and Allergy (ASCIA), updated April 2026
- Liu ZF et al. SCORTEN and novel prognostic markers in SJS/TEN: a systematic review and meta-analysis. Australas J Dermatol 2026;67 (doi 10.1111/ajd.70082)AU/NZAustralasian Journal of Dermatology, 2026
- UK guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults 2016 (Creamer D et al. J Plast Reconstr Aesthet Surg 2016;69:e119-e153)British Association of Dermatologists, 2016
- Heuer R, Paulmann M et al. S3 guideline: diagnosis and treatment of epidermal necrolysis (SJS and TEN), part 1. J Dtsch Dermatol Ges 2024;22:1448-66AWMF (German Dermatological Society), 2024
- Bastuji-Garin S et al. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol 2000;115:149-53Journal of Investigative Dermatology, 2000
- Noe MH et al. Development and validation of a risk prediction model for in-hospital mortality among patients with SJS/TEN: ABCD-10. JAMA Dermatol 2019;155:448-54JAMA Dermatology, 2019
- Wang CW et al. Randomized, controlled trial of TNF-alpha antagonist in CTL-mediated severe cutaneous adverse reactions. J Clin Invest 2018;128:985-96Journal of Clinical Investigation, 2018
- Lee EY et al. Proportion of antiepileptic drug-associated SJS and TEN: a meta-analysis. JAMA Dermatol 2026;162:912-21JAMA Dermatology, 2026
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Deploy to Cloudflare on push to main