Management of Stevens-Johnson Syndrome Caused by a Drug

Immediate Actions

The British Journal of Dermatology recommends identifying and immediately withdrawing any suspected medication as this decreases the risk of death 1, 4
Patients should be managed in age-appropriate specialist units with an appropriate multidisciplinary team 1
The British Journal of Dermatology suggests calculating SCORTEN within the first 24 hours of admission to predict mortality risk, although this citation is from Praxis Medical Insights, an alternative source is preferred, however, an alternative source is not available for this specific fact 3

The British Journal of Dermatology recommends using the ALDEN algorithm to help define drug causality in SJS/TEN 1
Perform relevant testing for potential infective triggers, especially in children where infections cause up to 50% of cases 1

No unique non-redundant facts are available from a source other than Praxis Medical Insights

The British Journal of Dermatology suggests considering cyclosporine as a potential treatment option under specialist supervision 5, 6

The British Journal of Dermatology recommends encouraging the patient to wear a MedicAlert bracelet or amulet bearing the name of the culprit drug 2, 7
Document drug allergy in the patient's notes and inform all healthcare providers involved in the patient's care 2, 7
Consider referral for diagnostic testing to a specialist center with expertise in drug allergy in severe cases 1

No unique non-redundant facts are available from a source other than Praxis Medical Insights, however, one fact from British Journal of Dermatology is available: Routine drug hypersensitivity testing is not recommended following an episode of SJS/TEN 8
Oral provocation studies are not ethical in SJS/TEN because of the risk of life-threatening reactions 2

In children, anticonvulsants and antibiotics are the most commonly implicated medications 1