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Click on image for details. None, Conflict of Interest: Stevens—Johnson syndrome and toxic epidermal necrolysis are severe, life-threatening mucocutaneous adverse drug reactions with a high morbidity and mortality that require immediate medical care. The aim of this article is to comprehensively review the published medical literature and frame management guidelines suitable in the Indian perspective.

The Indian Association of Dermatologists, Venereologists and Leprologists IADVL assigned the task of preparing these guidelines to its special interest group on cutaneous adverse drug reactions.

Steven Johnson Syndrome – Others

A draft of clinical recommendations was developed on the best available evidence which was also scrutinized and critically evaluated by the IADVL Academy of Dermatology. Based on the inputs received, this final consensus statement was prepared. A total of articles meta-analyses, prospective and retrospective studies, reviews [including chapters in books], previous guidelines [including Indian guidelines of ] and case series were critically evaluated and the evidence thus gathered was used in the preparation of these guidelines.

Owing to the systemic nature of the disease, a multidisciplinary approach in the management of these patients is helpful. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. The spectrum of Stevens-Johnson syndrome and toxic epidermal necrolysis: J Invest Dermatol ; The current understanding of Stevens-Johnson syndrome and toxic epidermal necrolysis.

Expert Rev Clin Immunol ;7: Stevens-Johnson syndrome and toxic epidermal necrolysis: Assessment of medication risks with emphasis on recently marketed drugs. Clinical, etiologic, and histopathologic features of Stevens-Johnson syndrome during an 8-year period at Mayo Clinic. Mayo Clin Proc ; A review of causes of Stevens-Johnson syndrome and toxic epidermal necrolysis in children.


Arch Dis Child ; Recent advances of pharmacogenomics in severe cutaneous adverse reactions: Immune and nonimmune mechanisms. Asia Pac Allergy ;5: Indian J Dermatol Venereol Leprol ; N Engl Tseven Med ; A systematic review and meta-analysis.

Marker of Steven Johnson Syndrome

BMC Med Genet ; An observational, retrospective case series study. Am J Clin Dermatol ; Granulysin is a key mediator for disseminated keratinocyte death in Stevens-Johnson syndrome and toxic epidermal necrolysis. Prognosis, sequelae, sgndrome, differential diagnosis, prevention, and treatment. J Am Acad Dermatol ; Guidelines for vitiligo, Stevens-Johnson syndrome, toxic epidermal necrolysis and psoriasis.

Introduction, history, classification, clinical features, systemic manifestations, etiology, and immunopathogenesis. Management of toxic epidermal necrolysis. A severity-of-illness score for toxic epidermal necrolysis. Simplifying the language of evidence to improve patient care: Strength of recommendation taxonomy SORT: A patient-centered approach to grading evidence in medical literature.

J Fam Pract ; Toxic epidermal necrolysis and Stevens-Johnson syndrome: Does early withdrawal of causative drugs decrease the risk of death? Treatment of toxic epidermal necrolysis.

J Plast Reconstr Aesthet Surg ; Inamadar AC, Palit A. Concept, causes, consequences and care. Roujeau JC, Revuz J. Intensive care in dermatology.

Recent Advances in Dermatology. Effect of age and early intervention with a systemic steroid, intravenous immunoglobulin or amniotic membrane transplantation on the ocular outcomes of patients with Stevens-Johnson syndrome. Korean J Ophthalmol ; Fifteen cases of toxic epidermal necrolysis Lyell. Acta Derm Venereol ; Toxic epidermal necrolysis and Stevens-Johnson’s disease. Phenytoin hypersensitivity reaction presenting with toxic epidermal necrolysis and severe hepatitis.

J Am Acad Dermatol ;12 1 Pt 2: Management of Stevens-Johnson syndrome and toxic epidermal necrolysis in children. Management of nonstaphylococcal toxic epidermal necrolysis: Follow-up study of 16 case histories. Effectiveness of corticosteroids in management and recurrent SJS. The outcome of Stevens-Johnson syndrome treated with corticosteroids. Effects of treatments on the mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis: Law EH, Leung M. Current evidence and implications for future research.


A year experience with toxic epidermal necrolysis. J Burn Care Rehabil ; Combination therapy of intravenous immunoglobulin and corticosteroid in the treatment of toxic epidermal necrolysis and Stevens-Johnson syndrome: A retrospective comparative study in China.

Int J Dermatol ; Causes and treatment outcomes of Stevens-Johnson syndrome and toxic epidermal necrolysis in 82 adult patients. Korean J Intern Med ; Comprehensive survival analysis of a cohort of patients with Stevens-Johnson syndrome and toxic epidermal johnskn. Successful treatment of Stevens-Johnson syndrome with steroid pulse therapy at disease onset. Am J Ophthalmol ; Improved treatment of the Stevens-Johnson syndrome.

Marker of Steven Johnson Syndrome

Effectiveness of early therapy with corticosteroids in Stevens-Johnson syndrome: Experience with 41 cases and a hypothesis regarding pathogenesis. Corticosteroid therapy in an additional 13 cases of Stevens-Johnson syndrome: A total series of 67 syndgome.

Allergy Asthma Proc ; Su P, Aw CW. Severe cutaneous adverse reactions in a local hospital setting: A 5-year retrospective study.

Corticosteroid treatment of erythema multiforme major Stevens-Johnson syndrome in children. Eur J Pediatr ; Clinical evaluation and analysis of biomarkers.

Askep Steven Johnson Syndrome

High-dose systemic corticosteroids can arrest recurrences of severe mucocutaneous erythema multiforme. Corticosteroids in toxic epidermal necrolysis.

Systemic corticosteroids in toxic epidermal necrolysis. A six month prospective study to find out the treatment outcome, prognosis and offending drugs in syndrom epidermal necrolysis from an urban institution in Kolkata. Indian J Dermatol ; Rai R, Srinivas CR. Suprapharmacologic doses of intravenous dexamethasone followed by cyclosporine in the treatment of toxic epidermal necrolysis.

Management of acquired bullous skin diseases. Adrenocorticosteroids and adrenocortical antagonists. Basic and Clinical Pharmacology. Treatment of toxic epidermal necrolysis with cyclosporin A. Toxic epidermal necrolysis in a child successfully treated with cyclosporin A and methylprednisolone. Early cyclosporine treatment of incipient toxic epidermal necrolysis induced by concomitant use of lamotrigine and sodium valproate.