Dermatology Emergency: Recognizing TEN/SJS

Definition by BSA Involvement SJS: SJS/TEN overlap: 10-30% BSA TEN: >30% BSA Key Clinical Features Prodromal flu-like symptoms Targetoid lesions with central necrosis Painful mucosal erosions (oral, ocular, genital) Positive Nikolsky sign Rapidly progressive epidermal detachment SCORTEN Prognostic Score Age >40, malignancy, heart rate >120, BSA >10%, BUN >28, serum bicarbonate 252 Initial Management Immediate drug withdrawal Transfer to burn unit/ICU Wound care similar to burn management Ophthalmology consultation Fluid resuscitation Pain management Infection surveillance Prognosis Mortality: SJS 1-5%, SJS/TEN 10-30%, TEN 30-50%