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Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the most severe forms of hypersensitivity reactions affecting the skin. Current terminology is based on maximal extent of epidermal detachment. SJS indicates cases with epidermal necrolysis that involve less than 10% of the body surface area, TEN with more than 30%, and overlap of SJS/TEN in between . Clinically, SJS/TEN are characterized by polymorphic lesions like erythematous macules, papules, plaque, vesicles, and bullae with Nikolsky's sign positive. Oral, genital, and conjunctival mucosae are often involved in the form of erosion or ulceration . Fever and malaise are the first symptoms of the disease . Incidence of SJS/TEN is 0.05–3 persons per million populations per year . Several drugs are highly suspected to cause SJS/TEN in adults, such as anti‐epileptics, anti‐infective sulfonamides, non‐steroidal anti‐inflammatory drugs, nevirapin, allopurinol, and antimicrobials (cephalosporins, aminopenicillins, quinolones, tetracyclines, and imidazole antifungals) . The list of causative drugs may vary from country to country . In children, anti‐infective sulfonamides, phenobarbital, carbamazepine, lamotrigine, and acetaminophen are frequently associated with SJS/TEN . However, SJS/TEN are rare in children with mortality rate of 7.5% . In this article, evaluation of children with SJS/TEN, investigation of causative drug/drugs, treatment, clinical
Pediatric Allergy and Immunology – Wiley
Published: Nov 1, 2013
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