management

Last edited 04/2022 and last reviewed 04/2022

Treatment is symptomatic, and includes:

• skin: calamine lotion and topical anaesthetics
• eyes: steroid drops, with referal to ophthalmologists for assessment
• systemic antibiotics are indicated if there are any features of infection There may be a role for systemic steroids (controversial) (1) - discuss with a dermatologist. Benefits of intravenous immunoglobulin treatment in Stevens-Johnson syndrome have been documented in some studies (1).

With respect to systemic interventions for treatment of Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome (2):

• found when compared to corticosteroids, etanercept may result in mortality reduction
• certainty of evidence for disease-specific mortality is very low for corticosteroids versus no corticosteroids, IVIG (intravenous immunoglobulins) versus no IVIG and cyclosporin versus IVIG

Reference:

• 1. Davis M.D.P. Picture of the Month-Diagnosis. Arch Pediatr Adolesc Med. 2006;160:802
• 2. Jacobsen A, Olabi B, Langley A, Beecker J, Mutter E, Shelley A, Worley B, Ramsay T, Saavedra A, Parker R, Stewart F, Pardo Pardo J. Systemic interventions for treatment of Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome. Cochrane Database of Systematic Reviews 2022, Issue 3. Art. No.: CD013130. DOI: 10.1002/14651858.CD013130.pub2