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Toxic Epidermal Necrolysis (TEN)MANAGEMENT

DERMATOLOGY PRESENTATIONS · 12 SECTIONS

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788 items

☷ Legend

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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/attcp54

Immediate stabilization

›Airway threats

›Oropharyngeal and mucosal erosions limiting airway patency

›Early anesthesia/critical care consultation for airway involvement

›Avoid blind nasotracheal intubation given mucosal fragility

›Bronchial epithelial sloughing

›Stridor or severe dyspnea mandates definitive airway

›Rapid sequence intubation with careful laryngoscopy

›Respiratory failure

›SpO2 < 92% on high-flow oxygen

›Rising PaCO2 with respiratory fatigue

›Circulatory and fluid threats

›High-output fluid losses analogous to burns

›IV access via unaffected skin (central line if needed)

›Avoid adhesive tape on affected skin

›Septic shock as leading cause of death

›MAP < 65 mmHg — initiate vasopressor support

›Broad-spectrum antibiotics within 1 hour of sepsis recognition

›Volume resuscitation targets

›Adjusted Parkland formula: approximately 2/3 of burn-equivalent BSA estimate

›Urine output target 0.5–1 mL/kg/hour

Immediate actions

›Drug identification and cessation

›Identify and immediately stop the culprit drug — most critical intervention

›Each day of continued exposure increases mortality

›Complete medication reconciliation including OTCs and supplements

›Drug cessation timing

›Discontinuation within 24 hours of diagnosis is strongly associated with improved survival

02History/hx69

Presentation pattern

›Prodromal symptoms preceding skin findings by 1–3 days

›Fever, malaise, myalgias

›Often mistaken for viral illness

›High-grade fever common

›Burning skin pain disproportionate to visible findings

›Pathognomonic feature early in course

›Pain often precedes visible blisters

›Mucosal symptoms

›Odynophagia and oral erosions

›Eye pain, photophobia, discharge

›Skin evolution timeline

›Erythematous macules to atypical targetoid lesions

›Onset on trunk and face, spreading centrifugally

›Coalescence within hours to days

›Confluent blisters progressing to sheet-like epidermal sloughing

›Positive Nikolsky sign on erythematous skin

›BSA detachment >=30% defines TEN

Drug exposure history

›Culprit drug identification

›New medication within past 4–28 days — most critical historical element

›Median latency 14 days from drug initiation to skin findings

›Complete list including prescriptions, OTCs, supplements

›High-risk drug classes

›Anticonvulsants: carbamazepine, phenytoin, lamotrigine, phenobarbital

›Allopurinol

›Sulfonamide antibiotics: TMP-SMX

›NSAIDs, especially oxicam type

03Physical Exam/exam64

Vitals and general

›Hemodynamic assessment

›Temperature

›High fever common in active disease

›Hypothermia as severe sepsis marker in established TEN

›Blood pressure and heart rate

›SBP < 90 mmHg warrants immediate vasopressor consideration

›Tachycardia from hypovolemia, pain, and systemic inflammation

›Respiratory rate

›Rate >=30 per minute as severity marker

›Oxygen saturation on room air and supplemental oxygen

›General appearance

›Distress level and pain severity

›Severe cutaneous pain disproportionate to visible skin change early

›Skin coverage estimation

›BSA detachment estimation: rule of nines or Lund-Browder chart

Skin examination

›Lesion morphology and distribution

›Erythematous macules and atypical targetoid lesions

›Central dusky or blistered component

›Irregular borders distinguishing from classic erythema multiforme targets

›Epidermal detachment

›Nikolsky sign: lateral pressure on erythematous skin causes epidermal slippage

›Asboe-Hansen sign: pressure on blister extends it laterally

›Distribution pattern

›Trunk and proximal extremities predominantly

›Face, palms, and soles may be involved

›Wound assessment

04Differential Diagnosis/ddx58

Life-threatening mimics

›Staphylococcal scalded skin syndrome (SSSS)

›Distinguishing features

›Subcorneal cleavage plane versus full-thickness epidermal necrosis in TEN

›No mucosal involvement in SSSS

›More common in neonates and infants; occurs in immunocompromised adults

›Biopsy distinguishes

›ICD-10 L00 (SSSS) versus L51.2 (TEN)

›Rapid frozen section skin biopsy within hours

›Acute graft-versus-host disease (GVHD)

›Distinguishing features

›Transplant history required

›Satellite cell necrosis on biopsy

›GI and hepatic involvement pattern

Drug-related and autoimmune blistering disorders

›Generalized bullous fixed drug eruption (GBFDE)

›Distinguishing features

›Well-demarcated round plaques

›Eosinophils and dermal melanophages on biopsy

›ICD-10 L27.0

›Clinical differentiation

›Lesion morphology more circumscribed

›Less systemic toxicity than TEN

›Autoimmune blistering diseases

›Pemphigus vulgaris

›Positive direct immunofluorescence (DIF): IgG at keratinocyte cell surfaces

›ICD-10 L10.0

›Bullous pemphigoid

05Laboratory Tests/lt69

Core labs

›Complete blood count

›Leukopenia as poor prognostic marker (SCORTEN component)

›WBC < 4.0 x 10^9/L carries higher mortality risk

›Leukocytosis suggests secondary bacterial infection

›Thrombocytopenia as severity marker

›SCORTEN includes platelet count < 150 x 10^9/L

›Metabolic panel and organ function

›Serum urea and creatinine

›Urea > 10 mmol/L is SCORTEN prognostic criterion

›Acute kidney injury from fluid losses and nephrotoxic drugs

›Glucose

›Blood glucose > 14 mmol/L is SCORTEN prognostic criterion

›Stress hyperglycemia common

›Electrolytes

›Hyponatremia from skin losses

›Potassium monitoring during aggressive fluid resuscitation

›Liver function tests

›Hepatic involvement in DRESS overlap assessment

›Drug-induced liver injury from culprit agent

›Bicarbonate

›Serum bicarbonate < 20 mmol/L is SCORTEN criterion

›Metabolic acidosis from fluid losses and sepsis

Infection and inflammation markers

›Blood cultures

›At onset of fever or sepsis signs

›Most common organisms: Staphylococcus aureus, Pseudomonas aeruginosa

›Gram-negative sepsis from mucosal barrier loss

06Diagnostic Tests/dt70

Scoring Systems

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

›Seven prognostic variables (1 point each)

›Age >=40 years

›Malignancy present

›Heart rate >=120 beats per minute

›BSA epidermal detachment >=10% on day 1

›Serum urea >10 mmol/L

›Serum bicarbonate <20 mmol/L

›Blood glucose >14 mmol/L

›Mortality prediction by score

›SCORTEN 0–1: predicted mortality 3.2%

›SCORTEN 2: predicted mortality 12.1%

›SCORTEN 3: predicted mortality 35.3%

›SCORTEN 4: predicted mortality 58.3%

›SCORTEN >=5: predicted mortality >90%

›Validation and limitations

›Meta-analysis confirms SCORTEN discriminates well (AUC ~0.83)

›Calculate on days 1 and 3 for dynamic assessment

›SCORTEN >=3 or BSA >10% warrants ICU-level care

›ABCD-10 score

›Alternative prognostic tool

›Age, bicarbonate, cancer, dialysis, BSA detachment >10%

›Comparable performance to SCORTEN in validation studies

›AUC approximately 0.86 vs 0.83 for SCORTEN

›Re-SCORTEN

›Revised SCORTEN incorporating novel inflammatory markers

›Proposed to improve mortality prognostication

07Disposition/dispo41

Admission criteria

›Universal admission requirement

›No patient with confirmed or suspected TEN should be discharged from ED

›TEN is a dermatologic emergency requiring inpatient care

›SJS/TEN overlap also requires admission

›Level of care determination

›SCORTEN >=3: ICU or burn unit mandatory

›BSA detachment >10%: burn unit or ICU

›Any hemodynamic instability, airway involvement, or multiorgan failure: ICU

›Burn unit criteria

›Preferred setting for all confirmed TEN

›Specialized wound care, temperature regulation, nutrition support

›Multidisciplinary team infrastructure

›Transfer if burn unit unavailable

›Initiate transfer early before clinical deterioration

›Stabilize airway and hemodynamics before transport

Transfer criteria

›Indications for urgent transfer

›Absence of burn unit or appropriate ICU at presenting facility

›All TEN patients ideally managed at burn center

›American Burn Association burn center referral criteria apply

›Transfer timing

›Transfer within first 24 hours of diagnosis optimizes outcomes

›Do not delay transfer to complete extensive workup

›Pre-transfer stabilization

›IV access, fluid resuscitation initiated

›Culprit drug identified and stopped

›Non-adherent wound dressings applied to denuded skin

08Treatment/t107

Immediate interventions

›Culprit drug cessation

›Immediate discontinuation of all suspected causative agents

›Priority intervention — each additional day of exposure worsens prognosis

›If multiple new drugs, use ALDEN score to identify most likely culprit

›Do not rechallenge with culprit drug

›Lifetime contraindication — document clearly in chart

Fluid resuscitation

›IV fluid strategy

›Modified Parkland formula

›Approximately 2/3 of burn-equivalent calculation

›Typical starting rate: 2–3 mL/kg per %BSA involved in first 24 hours

›Half of calculated volume in first 8 hours

›Fluid type

›Lactated Ringer's preferred (as in burn resuscitation)

›Albumin supplementation if serum albumin <20 g/L

›Monitoring and adjustment

›Urine output target 0.5–1 mL/kg/hour

›Avoid over-resuscitation (pulmonary edema risk)

›Reassess every 2–4 hours and adjust rate

Wound care

›Skin wound management

›Non-adherent wound dressings

›Petrolatum-impregnated gauze or silicone-based dressings

›Biosynthetic or biological temporary skin substitutes for large areas

›Do not debride intact blisters — protective role

›Infection prevention

›No prophylactic topical or systemic antibiotics — not recommended

›Chlorhexidine or silver-based dressings for infected wounds only

›Pain management

›IV opioids for wound care and dressing changes

›Pre-medicate 30–60 minutes before dressing changes

›Non-opioid adjuncts: IV acetaminophen, ketamine low-dose

›Mucosal wound care

›Oral cavity

›Saline or chlorhexidine mouthwash every 4–6 hours

›Viscous lidocaine for pain prior to mouth care

›Ophthalmic care

›Lubricating eye drops every 1–2 hours — preservative-free

›Topical antibiotic and steroid combinations (ophthalmology-directed)

›Amniotic membrane transplantation within 72 hours of eye involvement

›Genitourinary care

›Indwelling Foley catheter if urethral involvement

›Daily genital wound care to prevent adhesions

Nutritional support

›Enteral nutrition

›NPO only if significant oral mucosal or airway compromise

›Nasogastric or nasojejunal tube if unable to tolerate oral intake

›Early enteral nutrition within 24–48 hours preferred

›Nutritional targets

›High-calorie, high-protein diet (burn nutrition protocol)

›25–35 kcal/kg/day

›Protein 1.5–2 g/kg/day

›Gastric ulcer prophylaxis

›Proton pump inhibitor or H2 blocker for all patients

Systemic immunomodulatory therapy

›Cyclosporine

›3–5 mg/kg/day orally or IV for 7–14 days

›Meta-analysis (2025): mortality benefit vs. IVIG (RR 0.18)

›Most evidence-supported systemic therapy currently available

›Monitor renal function and trough levels

›Contraindications and cautions

›Active uncontrolled infection

›Severe renal impairment (adjust dosing)

›Drug interactions: avoid with nephrotoxins

›Etanercept

›25–50 mg subcutaneous single dose

›TNF-alpha inhibition — emerging evidence (RR 0.32 vs. supportive care)

›Particularly promising in moderate TEN

›Well-tolerated in initial studies

›Administration

›Single 50 mg SC dose if using higher dose protocol

›Some centers repeat at day 3 if inadequate response

›Systemic corticosteroids

›Methylprednisolone 1–2 mg/kg/day IV

›Controversial — widely used but evidence base limited

›May be combined with IVIG or cyclosporine in severe cases

›Risk: increased infection susceptibility

›Pulse dosing protocols

›Methylprednisolone 500 mg IV once daily for 3 days

›Taper based on clinical response

›IVIG

›2 g/kg total dose over 2–5 days

›Evidence mixed as monotherapy

›May be beneficial combined with corticosteroids

›Proposed mechanism: blockade of Fas-FasL apoptosis pathway

›Practical administration

›0.4–0.5 g/kg/day for 4–5 days

›Monitor for headache, hemolysis, renal impairment

›Thalidomide

›Absolutely contraindicated in TEN

›RCT stopped early due to increased mortality in TEN patients

›Do not use under any circumstances

›Plasmapheresis

›Reserved for refractory cases after failed standard therapy

›Removes drug and inflammatory mediators

›Evidence limited to case series and retrospective data

Supportive measures

›DVT prophylaxis

›Mechanical prophylaxis initially

›Pneumatic compression devices on unaffected limbs

›Pharmacological prophylaxis when hemostasis stable

›Anticoagulation considerations

›Low-molecular-weight heparin if no contraindication

›Monitor for wound bleeding

›Environmental and temperature

›Burn room environmental temperature 30–32 degrees C

›Prevents hypothermia from extensive skin loss

›Humidity control to prevent wound desiccation

›Psychological support

›PTSD develops in 30–50% of survivors

›Early psychiatry/psychology involvement

›Family support and communication

09Special Populations/sp78

Pregnancy

›Maternal considerations

›TEN in pregnancy carries dual mortality risk

›Maternal mortality significantly elevated

›Fetal/neonatal mortality from placental drug transfer and maternal instability

›Drug exposure assessment

›Anticonvulsant and antimicrobial use in pregnancy common culprits

›Lamotrigine dose changes in pregnancy alter drug levels

›Management modifications

›Obstetrics consultation immediately

›Fetal monitoring from viability

›Neonatology involvement for preterm delivery planning

›Fluid resuscitation

›Maintain uterine perfusion with MAP > 65 mmHg

›Left lateral decubitus positioning when feasible

›Systemic therapy safety in pregnancy

›Cyclosporine: limited data, fetal growth restriction risk

›IVIG: generally considered safer in pregnancy than immunosuppressants

›Systemic corticosteroids: associated with fetal risk but often used when maternal benefit outweighs

›Etanercept: insufficient data in TEN context; case-by-case decision

›Thalidomide

›Absolutely contraindicated in pregnancy — absolute teratogen

›Fetal considerations

›Drug transfer across placenta varies by agent

›Neonatal monitoring for cutaneous drug reactions if exposed in utero

›Preterm delivery planning

›Consider delivery if maternal instability refractory to treatment

Geriatric

›Age as independent risk factor

›Age >=40 years is a SCORTEN prognostic criterion

›Age >=65 associated with higher mortality

›Reduced skin healing capacity and immunosenescence

›Polypharmacy risk

›Multiple new medications common — increases diagnostic challenge

›ALDEN score particularly important in elderly with multiple culprit candidates

›Management modifications

›Fluid resuscitation

›Reduced fluid tolerance due to cardiac and renal reserve

›Closer monitoring for fluid overload and pulmonary edema

›Drug dosing

›Cyclosporine dose reduction for renal impairment (eGFR-guided)

›IVIG infusion rate reduction to prevent adverse effects

›Wound healing

›Slower re-epithelialization expected

›Higher pressure injury risk — specialized mattress and repositioning

›Nutritional support

›High protein targets may require aggressive supplementation

›Swallowing assessment given aspiration risk

›Prognostic counseling

›SCORTEN mortality estimates apply — document and discuss with family

›Goals of care discussion early in elderly patients with SCORTEN >=4

›Palliative care referral when appropriate

Pediatrics

›Epidemiology and etiology

›Incidence 0.4–1.2 cases per million children per year

›Anticonvulsants (phenobarbital, carbamazepine, lamotrigine) most common culprits in children

›Mycoplasma pneumoniae is important infectious trigger in pediatric TEN

›Infantile TEN (<=12 months)

›Case series suggest high incidence of Mycoplasma pneumoniae trigger

›Antibiotic (TMP-SMX) association in neonates with HIV exposure

›Clinical differences in children

›SCORTEN not validated in pediatric population

›Pediatric-specific risk stratification tools under development

›Clinical judgment and BSA-based assessment

›Mucosal involvement similar distribution to adults

›Ocular involvement 40–84% in pediatric series

›Higher psychological impact on parents and family

›Management modifications

›Fluid resuscitation

›Weight-based modified Parkland formula: 3 mL/kg per %BSA

›Close monitoring for over-resuscitation in small children

›Drug dosing in children

›Cyclosporine 3–5 mg/kg/day — same as adults, weight-based

›IVIG 2 g/kg over 2–5 days — same weight-based dosing

›Avoid systemic corticosteroids in children when possible (growth concerns)

›Pain management

›Weight-based IV morphine or fentanyl

›Child life specialist involvement

›Mycoplasma-triggered TEN

›Azithromycin or doxycycline (age >=8 years) for Mycoplasma eradication

›Evidence limited but generally practiced

10Background/b85

Epidemiology

›Incidence and prevalence

›Global incidence of TEN: 0.4–1.2 cases per million per year

›SJS/TEN spectrum combined: 1–6 cases per million per year

›Orphan disease designation in most jurisdictions

›Geographic variation

›Higher incidence in Asia related to HLA-associated drug exposure patterns

›Antibiotic-associated TEN varies by regional prescribing patterns

›Mortality

›Overall TEN mortality: 25–50%

›Largest dermatologic emergency by case fatality rate

›SCORTEN-predicted mortality correlates with observed outcomes

›Causes of death

›Sepsis is leading cause of death in TEN

›Multiorgan failure, pulmonary complications

›Cardiovascular morbidity and mortality elevated in survivors (2025 data)

›Long-term sequelae

›Ocular complications in up to 65% of survivors

›Dry eye syndrome, symblepharon, corneal scarring, visual impairment

›Progressive despite initial recovery

›Cutaneous sequelae

›Dyspigmentation, nail dystrophy, scarring

›Psychiatric sequelae

›PTSD in 30–50% of survivors

›Depression and anxiety common

›Cardiovascular risk

›Increased long-term cardiovascular morbidity and mortality in survivors (JAMA Dermatol 2025)

Pathophysiology

›Immune mechanism

›Delayed-type cytotoxic T-cell-mediated hypersensitivity

›CD8+ cytotoxic T-lymphocytes and NK cells drive epidermal necrosis

›Drug or drug-reactive metabolite acts as antigen

›Apoptosis pathways

›Fas-FasL pathway: keratinocyte programmed cell death

›Granulysin as key cytotoxic mediator released by CD8+ T cells

›Perforin-granzyme B pathway: direct keratinocyte killing

›TNF-alpha and inflammatory cascade

›TNF-alpha drives amplification of keratinocyte apoptosis

›Rationale for etanercept (TNF inhibitor) therapy

›Epidermal detachment mechanism

›Full-thickness epidermal necrosis

›Cleavage at dermoepidermal junction

›Sheet-like separation of entire epidermis

›Distinguishes from SSSS (subcorneal cleavage)

›Consequences of barrier loss

›Fluid, protein, and electrolyte losses

›Thermoregulation failure

›Infection portal — rapid bacterial colonization

›HLA pharmacogenomics

›HLA alleles present specific drug peptides to cytotoxic T cells

›HLA-B*15:02 — carbamazepine: risk in Southeast Asian and Han Chinese

›HLA-B*58:01 — allopurinol: risk in Black and Asian populations

›HLA-A*31:01 — carbamazepine: risk in Northern European and Japanese

›Risk modification

›Pre-treatment HLA screening reduces incidence in tested populations

›Taiwan screening program for HLA-B*15:02 reduced carbamazepine-TEN by 85%

Therapeutic Considerations

›Evidence quality for systemic therapy

›No Level A evidence (RCT) exists for any systemic immunomodulatory treatment

›Cochrane review 2022 found insufficient evidence to recommend any single agent

›All systemic therapy decisions based on retrospective data and meta-analyses

›Cyclosporine evidence base

›Multiple retrospective studies and meta-analyses suggest mortality benefit

›2025 systematic review (JDDG): RR 0.18 vs. IVIG for mortality

›Preferred by many expert centers as first-line systemic agent

›IVIG evidence base

›Mixed evidence — some studies show benefit, others no difference

›May benefit when combined with systemic corticosteroids

›2023 JAMA Dermatol study: plasmapheresis vs. IVIG after steroid failure

›Wound care evidence

›Biosynthetic skin substitutes (Biobrane) for large denuded areas

›Reduces pain and infection risk compared to repeated dressing changes

›Suitable where available and expertise exists

›Amniotic membrane transplantation for ocular involvement

›Within 72 hours of ocular involvement onset

›Significantly reduces risk of chronic ocular sequelae

›Antibiotic stewardship

›Prophylactic antibiotics not recommended

›International IJECRPH guidelines: treat infection, not colonization

›Selective decontamination protocols not standard

›Surveillance cultures guide targeted therapy

›Regular wound swabs to identify colonizing organisms

›Treat only when systemic signs of infection present

›Drug safety documentation

›Medical alert bracelet and documentation

›ALDEN causality scoring documents culprit drug probability

›Allergy registry notification

›Electronic health record permanent flag

11Patient Discharge Instructions/pdi50

copy discharge instructions

›Skin care at home

›Re-epithelialization expected over 2–3 weeks from disease onset

›Fragile new skin requires gentle care and sun protection

›SPF 50+ sunscreen to all healed areas — hyperpigmentation risk

›Wound dressing changes

›Follow burn/dermatology team instructions exactly

›Do not apply adhesive tape to newly healed skin

›Moisturization

›Apply fragrance-free emollient to healed skin 2–3 times daily

›Avoid harsh soaps or skin products during recovery

›Medications to avoid

›Absolute avoidance of the culprit drug for life

›Name of culprit drug documented in discharge papers

›Inform all healthcare providers of this allergy at every visit

›Structurally related compounds

›Anticonvulsant cross-reactivity within drug class

›Ask pharmacist to check for related compounds before any new prescription

›Carry written allergy documentation at all times

›Medical alert bracelet or card strongly recommended

›Allergy documented in pharmacy system

›Follow-up appointments

›Dermatology

›2–4 weeks post-discharge; then every 3–6 months for 1–2 years

›Monitor for cutaneous sequelae: dyspigmentation, nail dystrophy, scarring

›Ophthalmology

›Within 1–2 weeks post-discharge — mandatory

›Up to 65% develop chronic ocular complications requiring ongoing care

12References/r43

Guidelines and key sources

›Clinical Reviews in Allergy and Immunology 2018

›Lerch M et al. Current Perspectives on Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

›PMID 29188475

›Comprehensive review of SJS/TEN spectrum, pathophysiology, and management

›JAMA Dermatology 2023

›Lee EY, Knox C, Phillips EJ. Worldwide Prevalence of Antibiotic-Associated SJS/TEN

›Systematic review and meta-analysis of incidence data

›American Journal of Emergency Medicine 2024

›van Nispen C, Long B, Koyfman A. High Risk and Low Prevalence Diseases: SJS/TEN

›PMID 38631147

›Emergency medicine perspective on recognition and management

›Lancet 2017

›Duong TA et al. Severe Cutaneous Adverse Reactions to Drugs

›PMID 28476287

›Landmark review covering SJS/TEN spectrum management

›International Journal of Environmental Research and Public Health 2023

›Surowiecka A et al. Multidisciplinary Treatment in Toxic Epidermal Necrolysis

›PMID 36767584

›Nutrition, wound care, and supportive management

Prognostic and treatment trials

›JAMA Dermatology 2022

›Koh HK et al. Improvement of Mortality Prognostication — Re-SCORTEN

›SCORTEN validation and revision with novel inflammatory markers

›Koh HK et al. Assessment and Comparison of ABCD-10 and SCORTEN 2020

›ABCD-10 performance versus SCORTEN comparison

›Cochrane Database 2022

›Jacobsen A et al. Systemic Interventions for Treatment of SJS/TEN

Learn More: Toxic Epidermal Necrolysis (TEN)→

Comprehensive Clinical Review

Structured, evidence-informed, long-form analysis for deeper understanding.

Evidence & Review

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

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.