Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: An Update

Roni P. Dodiuk-Gad; Wen-Hung Chung; Laurence Valeyrie-Allanore; Neil H. Shear


Am J Clin Dermatol. 2015;16(6):475-493. 

In This Article

5 Conclusion

SJS/TEN is one of the few dermatological diseases that constitute a true medical emergency.

In the last decade, important progress has been achieved in our understanding of the pathogenesis, clinical presentation, and treatment of SJS/TEN. Furthermore, laboratory-based discovery of the HLA alleles associated with SJS/TEN induced by drugs has been translated into a clinical guideline-based test, which serves as a practical clinical tool for genetic screening to prevent SJS/TEN.

However, there is still no international consensus on the management of patients with SJS/TEN, and genetic screening is not well implemented in most countries.

This review has summarized up-to-date insights on SJS/TEN, including new discoveries on the genetic associations of SJS/TEN, and described a protocol for assessment and treatment. We hope that this summary will increase the awareness among physicians regarding the importance of genetic screening for decreasing the incidence of SJS/TEN and that our suggested management protocol will serve as a practical clinical tool for physicians.

Further research is needed to generate adequate in vitro and in vivo models for SJS/TEN, to develop novel treatments, to study the involvement of unknown pathogens, and to further investigate the mechanism of keratinocyte death.