Stevens-Johnson Syndrome (SJS)MANAGEMENT

DERMATOLOGY PRESENTATIONS · 12 SECTIONS

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527 items

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Cardiovascular Presentations71▾

Respiratory Presentations52▾

Neurological Presentations83▾

Gastrointestinal Presentations74▾

Genitourinary and Reproductive Presentations48▾

Infectious Disease Presentations148▾

Trauma Presentations89▾

Toxicologic Presentations80▾

Psychiatric Presentations26▾

Musculoskeletal and Rheumatologic Presentations96▾

Dermatology Presentations23▾

Allergic contact dermatitis Bullous Pemphigoid Cutaneous Abscess DRESS syndrome Eczema Herpeticum Erysipelas Erythema multiforme Henoch-Schönlein purpura Herpes Zoster (Shingles)Herpetic Whitlow Hidradenitis suppurativa Paronychia Pediculosis (Lice)Pemphigus Vulgaris Pilonidal Abscess Pressure injury Psoriasis (acute flare)Psoriasis Flare Staphylococcal Scalded Skin Syndrome Stevens-Johnson Syndrome (SJS)Toxic Epidermal Necrolysis (TEN)Urticaria (acute)Warfarin-induced Skin Necrosis

Environmental and Exposure Presentations27▾

Hematologic and Oncologic Presentations36▾

Pediatric-Specific Presentations19▾

Endocrine and Metabolic Presentations45▾

ENT and Maxillofacial Presentations27▾

Ophthalmologic Presentations19▾

Obstetric Presentations23▾

Systemic and Miscellaneous Presentations17▾

01Approach to the Critical Patient/attcp42

Immediate stabilization

›Airway assessment and protection

›Oropharyngeal or laryngeal mucosal involvement

›Early intubation if stridor, drooling, or voice change present

›Awake fiberoptic intubation preferred for anticipated difficult airway

›Respiratory compromise

›SpO2 target >94% on supplemental oxygen

›ARDS risk from bronchial epithelial involvement

›Initiate high-flow oxygen if SpO2 <94%

›Escalate to intubation for progressive hypoxia or respiratory fatigue

›Stop culprit drug immediately

›Single most important intervention — reduces mortality

›Identify all medications started within the past 4 weeks

›ALDEN score to rank causality when multiple agents implicated

›Hemodynamic and volume status

›IV access — two large-bore peripheral IVs or central venous access

›Fluid resuscitation for denuded skin fluid losses

›Crystalloid targeting approximately two-thirds of Parkland burn formula

›Reassess volume status every 4–6 hours

›Shock physiology triggers

›SBP <90 mmHg or MAP <65 mmHg

›Initiate norepinephrine for vasodilatory shock

Monitoring and escalation

›Mandatory monitoring bundle

›Continuous cardiac telemetry

›Tachycardia (HR >120) is a SCORTEN severity parameter

›Monitor for sepsis-driven hemodynamic deterioration

›Continuous pulse oximetry

02History/hx40

Drug exposure

›Medication timeline

›Onset typically 4–28 days after initiating a new medication

›All medications started in the past 4 weeks including OTC, herbals, supplements

›High-risk causative drug classes

›Sulfonamide antibiotics (TMP-SMX) — highest risk

›Anticonvulsants: carbamazepine, lamotrigine, phenytoin, phenobarbital

›Allopurinol — especially with HLA-B58:01 in at-risk populations

›Oxicam NSAIDs (piroxicam), ibuprofen, aspirin

›Nevirapine (antiretroviral)

›Immune checkpoint inhibitors — emerging cause

›Beta-lactam and fluoroquinolone antibiotics

›Prior severe drug reactions or known drug allergy

Prodromal and mucosal symptoms

›Pre-rash symptoms (1–3 days before skin findings)

›Fever, malaise, myalgias, influenza-like illness

›Skin pain and burning sensation before visible lesions appear

›Eye irritation, redness, photophobia, foreign body sensation

›Painful swallowing, oral pain, lip burning

›Dysuria, genital pain — mucosal prodrome

›Mucosal involvement prevalence

›Mucosal involvement occurs in approximately 80% of patients

›At least two mucosal surfaces affected in classic SJS

Skin and systemic symptoms

›Cutaneous progression

›Rash onset on face and trunk, spreading centrifugally

›Rapid spread — maximal within hours to 4 days

›Blistering, skin peeling, burning pain

03Physical Exam/exam38

Skin examination

›Mucocutaneous lesion morphology

›Atypical target lesions — flat, dusky center with at least 2 zones

›Purpuric macules coalescing into sheets of erythema

›Blistering and epidermal detachment

›BSA of detachment determines classification

›SJS: <10% BSA detachment

›SJS-TEN overlap: 10–30% BSA

›TEN: >30% BSA

›Nikolsky sign — epidermal separation with lateral digital pressure

›Asboe-Hansen sign — blister extension with downward pressure

›Distribution

›Face, trunk, proximal extremities involved first

›Acral involvement (palms, soles) in TEN

›Denuded erythematous dermis after blister roof removal

Mucosal assessment

›Oral cavity

›Hemorrhagic crusting of lips (pathognomonic appearance)

›Painful oral erosions, vesicles on buccal mucosa and tongue

›Pseudomembranes on oral mucosa

›Ocular examination

›Conjunctival hyperemia, chemosis, tearing

›Pseudomembranes on tarsal conjunctiva

›Corneal erosions — requires slit lamp assessment

›Symblepharon formation (conjunctival adhesions) — late finding

›Genital and urologic

›Urethral erosions, genital ulcers

›Urinary retention from urethral mucosal involvement

04Differential Diagnosis/ddx36

Life-threatening mimics

›Toxic epidermal necrolysis (TEN)

›ICD-10: L51.2

›>30% BSA detachment distinguishes TEN from SJS

›Mortality up to 50% — ICU/burn unit mandatory

›Staphylococcal scalded skin syndrome (SSSS)

›ICD-10: L00

›Superficial cleavage plane (subcorneal) — Nikolsky positive but no mucosal involvement

›Primarily in neonates and immunocompromised adults

›Skin biopsy differentiates: full-thickness necrosis in SJS vs subcorneal split in SSSS

Mucocutaneous reaction spectrum

›Erythema multiforme major (EM major)

›ICD-10: L51.1

›Classic target lesions with three zones (vs two-zone atypical in SJS)

›Usually infection-triggered (HSV), minimal BSA detachment

›Favors acral distribution (hands and feet)

›Drug reaction with eosinophilia and systemic symptoms (DRESS)

›ICD-10: L27.0

›Morbilliform exanthem without blistering or Nikolsky sign

›Eosinophilia, atypical lymphocytosis, visceral involvement (liver, kidneys)

›Onset 2–8 weeks after drug exposure (later than SJS)

›Acute generalized exanthematous pustulosis (AGEP)

›ICD-10: L27.1

›Non-follicular sterile pustules on erythematous base

›Neutrophilic pustules on biopsy — differentiates from SJS

›Rapid resolution (7–10 days) after drug withdrawal

Other conditions to exclude

›Pemphigus vulgaris

05Laboratory Tests/lt44

Severity and prognostic markers

›SCORTEN parameters — laboratory components

›Serum bicarbonate <20 mmol/l (1 point — acidemia from metabolic stress)

›Obtain arterial or venous blood gas on all patients

›Serum urea >10 mmol/l (1 point — renal involvement)

›Serum creatinine for additional renal function assessment

›Serum glucose >14 mmol/l (1 point — stress hyperglycemia)

›Serial glucose monitoring in ICU setting

Inflammatory and hematologic markers

›Complete blood count

›Leukopenia (<1 point in SCORTEN) or leukocytosis — infection risk marker

›Lymphopenia common in active SJS/TEN

›Thrombocytopenia — SCORTEN parameter (1 point)

›Peripheral eosinophilia favors DRESS over SJS

›Inflammatory markers

›C-reactive protein — elevation correlates with severity

›Procalcitonin — elevated with bacterial superinfection

›Serum albumin — hypoalbuminemia common, monitor for nutritional repletion

›Coagulation panel

›PT/INR and PTT — DIC risk in severe TEN

›Fibrinogen and D-dimer if DIC suspected

Metabolic and organ function

›Comprehensive metabolic panel

›Electrolytes — hyponatremia common from fluid shifts

›Liver enzymes (AST, ALT, ALP, bilirubin) — hepatic involvement possible

›Hepatotoxicity may indicate DRESS overlap

›LDH — elevated in severe epidermal necrolysis; correlates with disease activity

›Renal function

06Diagnostic Tests/dt52

Scoring Systems

›SCORTEN (Severity-of-Illness Score for TEN)

›Seven parameters — 1 point each

›Age >40 years

›Malignancy

›Heart rate >120 bpm

›Initial BSA epidermal detachment >10%

›Serum urea >10 mmol/l

›Serum glucose >14 mmol/l

›Serum bicarbonate <20 mmol/l

›Predicted in-hospital mortality by score

›Score 0–1: 3.2% mortality

›Score 2: 12.1% mortality

›Score 3: 35.8% mortality

›Score 4: 58.3% mortality

›Score >=5: >90% mortality

›Validated meta-analysis confirms SCORTEN discriminates well (AUROC ~0.82)

›Re-SCORTEN proposed revision adds inflammatory markers (NLR, LDH) for improved accuracy

›ABCD-10 score

›Four parameters: Age, Bicarbonate, Cancer, Dialysis, BSA at day 10

›Comparable discrimination to SCORTEN in some validation studies

›Useful for day-10 reassessment of prognosis

›ALDEN score (Algorithm of Drug Causality for Epidermal Necrolysis)

›Identifies most likely causative drug when multiple agents suspected

›Parameters: delay, dechallenge, prechallenge, drug presence at reaction onset, notoriety

›Score >=4 = very probable causality

MRI

›MRI role in SJS/TEN

07Disposition/dispo30

Admission indications

›All patients with confirmed or suspected SJS/TEN require inpatient admission

›No safe outpatient management for any BSA involvement

›Emergency department observation while arranging appropriate level of care

›Dermatology consultation before disposition finalized

Level of care determination

›ICU admission criteria

›SCORTEN >=3 — mandatory ICU-level care

›Hemodynamic instability or sepsis

›Respiratory failure or intubation requirement

›Extensive mucosal involvement (oropharyngeal, bronchial)

›Burn unit transfer criteria

›TEN (>30% BSA detachment) — burn unit preferred

›SJS-TEN overlap (10–30% BSA) — burn unit or ICU with burn expertise

›Burn center transfer associated with improved outcomes in TEN

›Dermatology ward admission

›SJS (<10% BSA) without hemodynamic compromise or airway threat

›Close monitoring with daily reassessment of BSA and SCORTEN

›Ophthalmology and dermatology co-management

Transfer considerations

›Transfer to burn center or tertiary center with SJS/TEN expertise

›Transfer within 24–48 hours for moderate-to-severe cases

›Stabilize before transfer: IV access, airway secured, fluid resuscitation initiated

›Transfer documentation

›Culprit drug identified and documented

›SCORTEN calculated and documented

›All consultations arranged or requested at receiving center

08Treatment/t77

Immediate interventions

›Culprit drug cessation

›Immediate and complete withdrawal of all suspected causative agents

›Each day of delay in drug withdrawal increases mortality by 30% (JAMA Dermatol 2021)

›Document in chart as high-severity allergy

›Fluid resuscitation

›Crystalloid (normal saline or lactated Ringer's)

›Target: approximately two-thirds of Parkland formula for equivalent BSA burn

›Parkland formula: 4 mL/kg/% BSA burned over 24 hours (SJS uses ~2.5 mL/kg/%)

›Titrate to urine output 0.5–1 mL/kg/hour

›Reassess every 4–6 hours — avoid over-resuscitation

›Colloid supplementation if hypoalbuminemia severe (albumin <20 g/L)

Wound and skin care

›Wound management principles

›Non-adherent dressings (petrolatum gauze, silicone-based) for denuded areas

›Avoid adhesive dressings directly on affected skin

›Change dressings daily with analgesia pre-medication

›Silver-containing topical agents (silver sulfadiazine) for antimicrobial cover

›Exception: avoid silver sulfadiazine if sulfonamide is the culprit drug

›Do not debride intact blisters — roof provides natural biological dressing

›Thermoregulation — maintain ambient temperature 30–32°C to reduce insensible losses

›Nutritional support

›NPO if swallowing unsafe due to oral mucosal erosions

›Nasogastric enteral feeding preferred over parenteral nutrition

›High-calorie, high-protein requirements (burn-equivalent hypermetabolic state)

›Dietitian consultation for nutritional targets

Mucosal care

›Ocular care

›Preservative-free lubricating eye drops — initiate immediately

›Topical corticosteroid drops (0.1% betamethasone)

›When initiated within 4 days of onset reduces chronic ocular sequelae

›Ophthalmology to direct regimen

›Amniotic membrane transplantation for severe acute ocular involvement

›Lysis of symblepharon — daily manual separation to prevent adhesions

›Oral and lip care

›Antiseptic mouthwash (chlorhexidine 0.12%)

›Topical anesthetic gel for pain (lidocaine 2%)

›Soft or liquid diet when oral intake possible

›Genital and urologic care

›Topical care to prevent adhesion and stricture formation

›Urology evaluation for urethral erosions

›Gynecology evaluation for vaginal adhesions

Systemic immunomodulatory therapy

›Cyclosporine A

›3–5 mg/kg/day orally or IV

›Duration: until re-epithelialization (typically 2–3 weeks)

›Taper over 1–2 weeks after disease stabilization

›Mechanism: inhibits IL-15 and perforin-dependent keratinocyte apoptosis

›Growing evidence supports benefit — reduces time to re-epithelialization

›Monitor cyclosporine levels, renal function, blood pressure

›Systemic corticosteroids

›IV methylprednisolone 1–2 mg/kg/day

›Use remains controversial — some data suggest prolonged disease course

›Early short course may be beneficial; avoid in active sepsis

›Some evidence for combination with cyclosporine

›IVIG (intravenous immunoglobulin)

›2 g/kg total dose divided over 2–5 days

›Evidence mixed — Cochrane 2022 meta-analysis showed no clear mortality benefit

›May have role in early disease or as adjunct therapy

›Avoid in IgA deficiency (anaphylaxis risk)

›Etanercept

›Single subcutaneous dose 50 mg

›Emerging data showing promise in reducing mortality and hospitalization

›TNF-alpha inhibition targets key apoptosis pathway

›Consider when cyclosporine contraindicated or unavailable

›Thalidomide — CONTRAINDICATED

›RCT stopped early due to significantly increased mortality

›Absolute contraindication in SJS/TEN management

Pain and infection management

›Pain management

›Opioid analgesia (morphine or hydromorphone) for severe skin pain

›Pre-medicate before dressing changes

›PCA pump in cooperative patients

›Avoid NSAIDs if implicated as causative agent

›Gabapentin for neuropathic component

›Infection prevention and treatment

›Do not use prophylactic systemic antibiotics

›Increases risk of resistant organism colonization

›Surveillance wound cultures every 48 hours

›Treat documented infections with culture-directed antibiotics

›Central line and Foley catheter care per burn unit protocols

›Mupirocin topical for Gram-positive coverage of wound cultures if indicated

09Special Populations/sp45

Pregnancy

›Pregnancy-specific considerations

›SJS/TEN in pregnancy is rare but carries high maternal and fetal mortality

›All medications evaluated for teratogenicity of causative drug

›Systemic therapy modifications in pregnancy

›Cyclosporine A: Category C; use if benefit outweighs risk

›Corticosteroids: relatively safe; preferred systemic agent

›IVIG: generally considered safe in pregnancy

›Etanercept: limited data in pregnancy — Category B; individualize

›Thalidomide: absolutely contraindicated in pregnancy (Category X, teratogen)

›Fetal monitoring

›Continuous fetal heart rate monitoring in viable pregnancies

›Maternal hypotension and hypoxia increase fetal distress risk

›Obstetric consultation mandatory for all pregnant patients

›Premature delivery may occur due to maternal systemic stress

Geriatric

›Age-related considerations

›Age >40 years is a SCORTEN parameter — independent mortality predictor

›Reduced physiologic reserve — accelerated deterioration

›Polypharmacy — increases probability of drug-triggered SJS

›Allopurinol most common causative drug in elderly

›Fluid resuscitation caution

›Reduced cardiac reserve — risk of fluid overload and pulmonary edema

›Echocardiography-guided resuscitation preferred

›Renal function

›Higher baseline creatinine — adjust drug dosing accordingly

›Cyclosporine nephrotoxicity risk increased in pre-existing CKD

›Thermoregulation impaired — higher ambient temperature requirement

10Background/b64

Epidemiology

›Incidence and prevalence

›SJS incidence: approximately 1–6 cases per million per year worldwide

›TEN incidence: approximately 0.4–1.2 cases per million per year

›No clear sex predilection — slight female predominance in some studies

›Mean age of onset varies; bimodal distribution in some registries (young and elderly)

›Mortality

›SJS mortality approximately 10%

›SJS-TEN overlap mortality approximately 30%

›TEN mortality up to 50% without optimal burn unit management

›Drug causality

›Drugs account for approximately 70–80% of adult SJS cases

›Infections account for 30% of pediatric cases (Mycoplasma predominant)

›Sulfonamide antibiotics — highest risk per prescription

›Antibiotic-associated SJS/TEN: systematic review and meta-analysis (Lee et al, JAMA Dermatol 2023)

›Long-term sequelae

›>80% of SJS/TEN survivors report at least one long-term sequela

›Ocular sequelae in approximately 60%

›Oral mucosal sequelae in approximately 50%

›Psychological sequelae (PTSD, depression, anxiety) in approximately 45%

›Elevated cardiovascular mortality persisting 4–7 years after episode (JAMA Dermatol 2025)

Pathophysiology

›Immune mechanism

›Delayed-type (Type IV) hypersensitivity reaction — T-cell mediated

›CD8+ cytotoxic T lymphocytes and NK cells drive keratinocyte apoptosis

›Granulysin — key cytotoxin; serum levels correlate with severity

›Perforin-granzyme pathway and FasL-Fas system both implicated

›Drug antigen presentation via HLA class I molecules — pharmacogenomic mechanism

›Hapten model: drug binds to HLA and creates new peptide-HLA complex

›Altered peptide repertoire model in carbamazepine-HLA interactions

›Genetic susceptibility

›HLA-B15:02 — carbamazepine SJS in Han Chinese and Southeast Asian populations

›HLA-B58:01 — allopurinol SJS/TEN in multiple Asian and African populations

›HLA-B57:01 — abacavir hypersensitivity (distinct but related mechanism)

›Non-HLA genetic factors also implicated (cytokine gene polymorphisms)

›Epidermal necrosis mechanism

›Widespread keratinocyte apoptosis leads to full-thickness epidermal necrosis

›Subepidermal cleavage with detachment of necrotic epidermis

›Mucosal epithelium (oral, ocular, genital, bronchial) simultaneously affected

›Inflammatory cytokines: TNF-alpha, IFN-gamma, IL-15, IL-17, IL-6

›SJS-TEN spectrum

›SJS: <10% BSA epidermal detachment

›SJS-TEN overlap: 10–30% BSA

›TEN: >30% BSA

›Distinct from erythema multiforme: different pathogenesis, triggers, and outcomes

Therapeutic Considerations

›Drug withdrawal — foundation of management

›Immediate cessation reduces antigen drive and halts immune activation

›ALDEN score aids identification of culprit when multiple drugs present

›Each day of continuation increases mortality independently

›Cyclosporine A evidence base

›Inhibits T-cell activation and IL-15/granzyme B expression

›Retrospective and prospective data show reduced re-epithelialization time

›Ingen-Housz-Oro et al (J Invest Dermatol 2025) — current best practice review

›No large RCT yet — evidence Class IIa (reasonable to use based on multiple studies)

›IVIG evidence base

›Cochrane systematic review 2022 (Jacobsen et al) — no significant mortality benefit

›Earlier RCTs underpowered; heterogeneous dosing protocols

›Evidence Class IIb — may be considered but benefit unproven

›Etanercept emerging evidence

›Targets TNF-alpha — key upstream cytokine in keratinocyte apoptosis

›Single SC 50 mg dose associated with faster re-epithelialization in Chinese RCT

›International validation ongoing — promising Class IIa evidence

›Multidisciplinary care model

›Burn unit co-management associated with best outcomes

›Ophthalmology involvement within 24 hours reduces chronic ocular sequelae

›Pharmacogenomic counseling and HLA testing before discharge for at-risk populations

11Patient Discharge Instructions/pdi35

copy discharge instructions

›Medication allergy warning

›The medication that caused your skin reaction has been permanently documented as a severe allergy in your medical record

›Never take this medication or any chemically related medication again

›Obtain a medical alert bracelet or wallet card listing the specific drug to avoid

›Tell every doctor, dentist, pharmacist, and emergency provider about this allergy at every visit

›Skin and wound recovery

›Your skin will continue to heal over the coming 1–3 weeks

›Keep affected areas clean and protected from sun exposure

›Use sunscreen SPF 30 or higher on all areas that had skin involvement

›Photosensitivity may persist for months — avoid prolonged sun exposure

›Skin colour changes (darker or lighter areas) are expected and may last months to years

›Eye care instructions

›Attend all scheduled ophthalmology appointments — chronic eye problems occur in up to 65% of survivors

›Use all prescribed eye drops exactly as directed

›Return to emergency immediately for sudden vision change, severe eye pain, or new redness

›Return to emergency department immediately for

›Any new blistering, skin peeling, or painful rash — especially after starting a new medication

›Mouth sores, eye redness or pain, or painful urination that develops after any new drug

›Fever with a new rash of any kind

›Difficulty breathing, chest tightness, or new cough

›Severe eye pain, sudden vision change, or inability to open eyes

›Ongoing follow-up appointments

›Dermatology within 2–4 weeks of discharge

›Ophthalmology — ongoing follow-up for at least 1 year

›Family doctor within 1 week for medication review and wound check

›Urology or gynecology if genital areas were involved

›Mental health support — depression, anxiety, and PTSD are common after this illness

12References/r24

Guidelines and key sources

›Duong TA, Valeyrie-Allanore L, Wolkenstein P, Chosidow O. Severe Cutaneous Adverse Reactions to Drugs. Lancet. 2017. PMID 28476287

›Comprehensive review of SJS/TEN pathogenesis, diagnosis, and management

›Lee EY, Knox C, Phillips EJ. Worldwide Prevalence of Antibiotic-Associated Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review and Meta-analysis. JAMA Dermatology. 2023

›Incidence and antibiotic-associated epidemiology

›Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T. Current Perspectives on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. Clinical Reviews in Allergy and Immunology. 2018. PMID 29188475

›Pathophysiology and clinical management review

›van Nispen C, Long B, Koyfman A. High Risk and Low Prevalence Diseases: Stevens Johnson Syndrome and Toxic Epidermal Necrolysis. American Journal of Emergency Medicine. 2024. PMID 38631147

›Emergency medicine-focused management review

›Maverakis E, Wang EA, Shinkai K, et al. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Standard Reporting and Evaluation Guidelines: Results of a National Institutes of Health Working Group. JAMA Dermatology. 2017

›NIH consensus guidelines for SJS/TEN evaluation and reporting

›Jacobsen A, Olabi B, Langley A, et al. Systemic Interventions for Treatment of Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and SJS/TEN Overlap Syndrome. Cochrane Database of Systematic Reviews. 2022

›Cochrane review — no mortality benefit from IVIG; limited evidence for all systemic agents

›Ingen-Housz-Oro S, Matei I, Gaillet A, et al. Diagnosing and Managing Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Adults: Review of Evidence 2017-2023. Journal of Investigative Dermatology. 2025. PMID 40019457

›Current best practice synthesis including cyclosporine and etanercept evidence

›Kridin K, Bruggen MC, Chua SL, et al. Assessment of Treatment Approaches and Outcomes in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Pan-European Multicenter Study. JAMA Dermatology. 2021

›Real-world treatment outcomes across European centers

›Koh HK, Fook-Chong SMC, Lee HY. Improvement of Mortality Prognostication in Patients With Epidermal Necrolysis: Proposed Revision of SCORTEN (Re-SCORTEN). JAMA Dermatology. 2022

›SCORTEN validation and revised scoring with inflammatory markers

›Chiu HY, Chiu YM. Risk of Cardiovascular Morbidity and Mortality in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Survivors. JAMA Dermatology. 2025

›Long-term cardiovascular risk data (3-fold ischemic heart disease, 5-fold cerebrovascular risk)

›Sotozono C, Ueta M. Updates on the Ocular Manifestations and Treatment of SJS/TEN. Allergology International. 2025. PMID 40500649

›Current ocular management including amniotic membrane and betamethasone drops

›Martinez Villarreal JD, Cardenas-de la Garza JA, Ionescu MA, et al. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Current Management and Innovative Therapies. International Journal of Dermatology. 2025. PMID 40231717

›Emerging therapies including etanercept evidence

Learn More: Stevens-Johnson Syndrome (SJS)→

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Reviewed by SymptomDx Medical Team · Last reviewed August 18, 2026

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