Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Key points

• • These are severe reactions, most often to drugs, in which the skin and the linings of the mouth, eyes and genitals blister and shed.
• • They lie on a spectrum: Stevens-Johnson syndrome affects a smaller area of skin, and toxic epidermal necrolysis a larger area.
• • Common triggers include certain antiepileptics, sulfa drugs, allopurinol and some antibiotics.
• • The skin becomes painful and red, then peels off in sheets, and a gentle sideways push can shear it (a positive Nikolsky sign).
• • Because so much skin is lost, there is a danger of fluid loss and infection like a severe burn, so it is a dangerous and life-threatening condition.