Stevens-Johnson syndrome/toxic epidermal necrolysis: initial assessment

What you need to knowConsider a diagnosis of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in a person with rash and multi-site mucositis who has been started on a new drug within the previous two monthsCutaneous pain is a prominent symptom in SJS/TEN and precedes blistering and sloughing of involved epidermisEarly transfer of patients to an intensive care unit or burns unit reduces mortality in SJS/TENA student in her late teens is started on lamotrigine for suspected epilepsy. Thirteen days later her eyes become red and itchy, and the following day she develops a sore throat, chapped lips, and widespread skin itching. She attends the emergency department, is diagnosed with a viral illness, and prescribed antihistamine. The next day she has a fever, malaise, facial rash, and oral ulceration. Within 24 hours the rash spreads to her torso and limbs and has started to blister. She is admitted to the intensive care…
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