Drug Reactions - Stevens-Johnson Syndrome vs Toxic Epidermal Necrolysis

Question 1

Stevens-Johnson syndrome
-causative drugs
-presentation
-management

Answer 1

Severe systemic skin reaction affecting skin and mucosa => U10% of skin affected

AEDs - lamotrigine, carbamazepine, phenytoin
ABx - sulphonamides
Antinflammatories - NSAIDS

Maculopapular rash => can develop into vesicles, bullae
If skin rubbed gently => blisters, erosions appear
Mucosal and systemic involvement

URGENT ADMISSION => ICU
Stop causative drug
Supportive fluids, analgesia
IVIG, immunosuppresants
Protect skin with non-stick dressing

Question 2

Toxic epidermal necrolysis
-causative drugs
-presentation
-management

Answer 2

LIFE THREATENING skin reaction affecting skin => 30%+ of skin affected

AEDs - lamotrigine, carbamazepine, phenytoin
ABx - sulphonamides
Antinflammatories - NSAIDS

Maculopapular rash => can develop into vesicles, bullae
If skin rubbed gently => blisters, erosions appear
Mucosal and systemic involvement

URGENT ADMISSION => ICU
Stop causative drug
Supportive fluids, analgesia
IVIG, immunosuppresants
Protect skin with non-stick dressing