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Stevens-Johnson syndrome

INTRODUCTION AND TERMINOLOGY — Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe mucocutaneous reactions, most commonly triggered by medications, characterized by extensive necrosis and detachment of the epidermis [1]. According to a widely accepted classification, SJS and TEN are considered a disease continuum and are distinguished chiefly by severity, based upon the percentage of body surface involved with blisters and erosions (table 1) [2,3]:

SJS is the less severe condition, in which skin detachment is <10 percent of the body surface (picture 1A-C). Mucous membranes are affected in over 90 percent of patients, usually at two or more distinct sites (ocular, oral, and genital).

TEN involves detachment of >30 percent of the body surface area (BSA) (picture 2A-D). Mucous membranes are also involved in over 90 percent of patients.

SJS/TEN overlap describes patients with skin detachment of 10 to 30 percent of BSA.

We will use the term "SJS/TEN" to refer collectively to SJS, TEN, and SJS/TEN overlap syndrome.

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