Wednesday, October 23, 2013

Stevens-Johnson syndrome (SJS) - Toxic Epidermal Necrolysis (TEN)

I believe both of them are of similar morphology, though oral lesions and respiratory tract involvement are more noticed at SJS with total body distribution less than 30%

TEN is more severe as it may involve  more than 30 to even 100% of the total body surface !

both of them are very devastating conditions with high mortality rates and bad prognosis,

during my residency, I've seen a case of SJS and trust me even when this case is presentable it may raise confusion upon the differential with other similar conditions and with Staphylococcal scalded skin syndrome (I'd be glad if there are any special or more diagnostic criteria to know or if you may add).

both are managed by admission to a Burn Unit , as they both carry the same Mortality Risk factors, Sepsis and Dehydration

in SJS treatment of choice besides prophylactic antibiotics would be Intravenous Immunoglobulins IVIg , also cyclophosphamides and other Immunosuppressives may be considered .

however in TEN , Immunosuppressives may exacerbate the condition ! and antibiotics aren't indicated for this as a primary condition ! and this just to add to our trouble at these conditions



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