What is the difference between sjs and ten

Books about skin diseases Books about the skin Dermatology Made Easy book. DermNet NZ does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice. Lyell syndrome, Erythema multiforme exudativum, Ectodermosis erosiva pluriorificialis. Reaction to external agent. Approach to the acute, generalized, blistering patient.

Semin Cutan Med Surg ; — Cotliar J. Approach to the patient with a suspected drug eruption. Semin Cutan Med Surg ; Phenotypic diversity in delayed drug hypersensitivity: An immunologic explanation. Mount Sinai Journal of Medicine ; — Mockenhaupt M. Severe drug-induced skin reactions: clinical pattern, diagnostics and therapy. Journal der Deutschen Dermatologischen Gesellschaft ; 7: — R oujeau J-C.

Clinical heterogeneity of drug hypersensitivity. Toxicology ; — Life-threatening acute adverse cutaneous drug reactions. Clinics in Dermatology ; 23; — Patch testing in severe cutaneous adverse drug reactions, including Stevens—Johnson syndrome and toxic epidermal necrolysis.

Contact Dermatitis. J Am Acad Dermatol ; 65—8. Besides conventional drugs, herbal remedies and new biologicals should be considered as causative agents. The increased risk of hypersensitivity reactions to certain drugs may be linked to specific HLA antigens.

However, many factors contributing to epidermal necrolysis still have to be identified, especially in virus-induced and autoimmune forms of epidermal necrolysis not related to drugs. Nasopharyngeal, esophageal, and genital mucosal involvement with blisters, erosions as well as secondary development of strictures also play a role.

Diagnosis is clinical. Lesions spontaneously resolve but frequently In later stages of TEN, differential diagnosis includes the following:. Manifestations include high fever, hypotension, diffuse erythematous rash, and multiple organ dysfunction, which It represents the maximum severity of various skin disorders. Diagnosis is by history and examination Paraneoplastic pemphigus Pemphigus Vulgaris Pemphigus vulgaris is an uncommon, potentially fatal, autoimmune disorder characterized by intraepidermal blisters and extensive erosions on apparently healthy skin and mucous membranes.

In children, TEN is less common and must be distinguished from staphylococcal scalded skin syndrome Staphylococcal Scalded Skin Syndrome Staphylococcal scalded skin syndrome is an acute epidermolysis caused by a staphylococcal toxin. Infants and children are most susceptible. Symptoms are widespread bullae with epidermal sloughing Characteristics of staphylococcal scalded skin syndrome usually include sparing of mucous membranes, absence of risk factors for TEN eg, drug history , and clinical suspicion of staphylococcal infection.

Severe toxic epidermal necrolysis is similar to extensive burns; patients are acutely ill, may be unable to eat or open their eyes, and suffer massive fluid and electrolyte losses. They are at high risk of infection, multiorgan failure, and death. Drugs, especially sulfa drugs, antiseizure drugs, and antibiotics, are the most common Treatment is most successful when Stevens-Johnson syndrome and toxic epidermal necrolysis are recognized early and treated in an inpatient dermatologic or intensive care unit setting; treatment in a burn unit Treatment Burns are injuries of skin or other tissue caused by thermal, radiation, chemical, or electrical contact.

Burns are classified by depth superficial and deep partial-thickness, and full-thickness Ophthalmology consultation and specialized eye care are mandatory for patients with ocular involvement. Potentially causative drugs should be stopped immediately. Patients are isolated to minimize exposure to infection and are given fluids, electrolytes, blood products, and nutritional supplements as needed.

Skin care includes prompt treatment of secondary bacterial infections and daily wound care as for severe burns. Prophylactic systemic antibiotics are controversial and often avoided. Drug treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis is controversial. The use of systemic corticosteroids remains controversial. It had been thought by many experts to increase mortality because of increased rates of infection and the risk of masking sepsis.

However, some reports show improved outcomes with early corticosteroid therapy. Plasmapheresis Plasmapheresis Apheresis refers to the process of separating the cellular and soluble components of blood using a machine. Apheresis is often done on donors where whole blood is centrifuged to obtain individual Early high-dose IVIG 2. However, despite some remarkable initial results using high-dose IVIG for toxic epidermal necrolysis, further clinical trials involving small cohorts have reported conflicting results, and a retrospective analysis has suggested no improvement or even higher than expected mortality 1 Treatment reference Stevens-Johnson syndrome and toxic epidermal necrolysis are severe cutaneous hypersensitivity reactions.