The objective of this discussion paper is to illuminate the importance of early identification and treatment of Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN). SJS/TEN may occur as quickly as 4 days, more commonly 4 to 8 weeks after starting a new medication and early identification is essential.
Methods:
A review of literature revealed there is a lack of diagnostic awareness related to the clinical presentation and diverse populations at risk for this devastating syndrome.
Results:
A Boolean search was conducted, and six quantitative and qualitative research articles were discovered that indicate a knowledge disparity between “rash” versus SJS/TEN. Research indicates evidence-based best clinical practices for nurses and health care practitioners for assessment of risks, clinical presentation, and treatment.
Conclusions:
Prompt diagnosis and discontinuation of the suspected medication will reduce potential life-threatening sequelae.
De BustrosP.BaldeaA.SanfordA.JoyceC.AdamsW.BouchardC. (2022). Review of culprit drugs associated with patients admitted to the burn unit with the diagnosis of Stevens–Johnson syndrome and toxic epidermal necrolysis. Syndrome. Burns, 48(7), 1561–1573. https://doi.org/10.1016/j.burns.2021.08.009
4.
FrantzR.HuangS.AreA.MotaparthiK. (2021). Stevens–Johnson syndrome and toxic epidermal necrolysis: A review of diagnosis and management. Medicina, 57(9), Article 895. https://doi.org/10.3390/medicina57090895
GoldmanJ. L.ChungW.-H.LeeB. R.ChenC.-B.LuC.-W.HoetzeneckerW.MichelettiR.YasudaS. U.MargolisD. J.ShearN. H.StruewingJ. P.PirmohamedM. (2019). Adverse drug reaction causality assessment tools for drug-induced Stevens–Johnson syndrome and toxic epidermal necrolysis: Room for improvement. European Journal of Clinical Pharmacology, 75(8), 1135–1141. https://doi.org/10.1007/s00228-019-02670-9
7.
HasegawaA.AbeR. (2020). Recent advances in managing and understanding Stevens- Johnson syndrome and toxic epidermal necrolysis. F1000Research, 9(612), Article 612. https://doi.org/10.12688/f1000research.24748.1
MaityS.BanerjeeI.SinhaR.JhaH.GhoshP.MustafiS. (2020). Nikolsky’s sign: A pathogenomic boon. Journal of Family Medicine and Primary Care, 9(2), 526–530. https://doi.org/10.4103/jfmpc.jfmpc_889_19
O’ReillyP.KennedyC.MeskellP.CoffeyA.DelaunoisI.DoreL.HowardS.RamsayB.ScanlonC.WilsonD. M.WhelanB.RyanS. (2020). The psychological impact of Stevens-Johnson syndrome and toxic epidermal necrolysis on patients’ lives: A Critically Appraised Topic. The British Journal of Dermatology, 183(3), 452–461. https://doi.org/10.1111/bjd.18746
18.
RossiG.da Silva CartellA.Marchiori BakosR. (2021). Dermoscopic aspects of cutaneous adverse drug reactions. Dermatology Practical & Conceptual, 11(1), Article e2021136. https://pubmed.ncbi.nlm.nih.gov/33614215/
YangM.-S.LeeJ. Y.KimJ.KimG.-W.KimB.-K.KimJ.-Y.ParkH.-W.ChoS.-H.MinK.-U.KangH.-R. (2016). Incidence of Stevens–Johnson syndrome and toxic epidermal necrolysis: A nationwide population-based study using National health insurance database in Korea. PLOS ONE, 11(11), Article e0165933. https://doi.org/10.1371/journal.pone.0165933
