Stevens-Johnson syndrome classification: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Stevens-Johnson syndrome}} | {{Stevens-Johnson syndrome}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{AHS}} | ||
==Overview== | ==Overview== | ||
There is agreement in the medical literature that [[Stevens-Johnson syndrome]] can be considered a milder form of [[toxic epidermal necrolysis]] (TEN). However, there is debate whether it falls on a spectrum of disease that includes [[erythema multiforme]] and erythema multiforme major (also known as erythema multiforme majus).<ref>{{cite journal |author=Carrozzo M, Togliatto M, Gandolfo S |title=[Erythema multiforme. A heterogeneous pathologic phenotype] |journal=Minerva Stomatol |volume=48 |issue=5 |pages=217-26 |year=1999 |pmid=10434539}}</ref><ref>{{cite journal |author=Farthing P, Bagan J, Scully C |title=Mucosal disease series. Number IV. Erythema multiforme |journal=Oral Dis |volume=11 |issue=5 |pages=261-7 |year=2005 |pmid=16120111}}</ref><ref>{{cite journal |author=Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC |title=Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme |journal=Archives of dermatology |volume=129 |issue=1 |pages=92-6 |year=1993 |pmid=8420497 | doi = 10.1001/archderm.129.1.92 <!--Retrieved from CrossRef by DOI bot-->}}</ref><ref>Ogundele O, Silverberg MA. Erythema Multiforme. eMedicine.com. URL: | There is agreement in the medical literature that [[Stevens-Johnson syndrome]] can be considered a milder form of [[toxic epidermal necrolysis]] (TEN). Stevens-Johnson Syndrome involves less than 10 percent of body surface area while TEN involve more than 30 percent body surface area. However, there is debate whether it falls on a spectrum of disease that includes [[erythema multiforme]] and erythema multiforme major (also known as erythema multiforme majus).<ref>{{cite journal |author=Carrozzo M, Togliatto M, Gandolfo S |title=[Erythema multiforme. A heterogeneous pathologic phenotype] |journal=Minerva Stomatol |volume=48 |issue=5 |pages=217-26 |year=1999 |pmid=10434539}}</ref><ref>{{cite journal |author=Farthing P, Bagan J, Scully C |title=Mucosal disease series. Number IV. Erythema multiforme |journal=Oral Dis |volume=11 |issue=5 |pages=261-7 |year=2005 |pmid=16120111}}</ref><ref>{{cite journal |author=Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC |title=Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme |journal=Archives of dermatology |volume=129 |issue=1 |pages=92-6 |year=1993 |pmid=8420497 | doi = 10.1001/archderm.129.1.92 <!--Retrieved from CrossRef by DOI bot-->}}</ref><ref>Ogundele O, Silverberg MA. Erythema Multiforme. eMedicine.com. URL: http://www.emedicine.com/emerg/topic173.htm. Accessed on: May 6, 2007.</ref><ref name="pmid12164739">{{cite journal | ||
| author = Auquier-Dunant A, Mockenhaupt M, Naldi L, Correia O, Schröder W, Roujeau JC | | author = Auquier-Dunant A, Mockenhaupt M, Naldi L, Correia O, Schröder W, Roujeau JC | ||
| title = Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study | | title = Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study | ||
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==Classification== | ==Classification== | ||
Skin lesions can be classified into 5 Different Categories as defined below<ref name="pmid8420497">{{cite journal| author=Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC| title=Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. | journal=Arch Dermatol | year= 1993 | volume= 129 | issue= 1 | pages= 92-6 | pmid=8420497 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8420497 }}</ref>: | |||
* Bullous Eythema Multiforme: Detachment below 10% of the body surface area (BSA) plus localized typical targets or raised atypical targets | |||
* Stevens-Johnson Syndrome: Detachment below 10% of the body surface area plus widespread erythematous or purpuric macules or flat atypical targets | |||
* Stevens-Johnson and Toxic Epidermal Necrolysis Overlap: Detachment between 10% and 30% of the body surface area plus widespread purpuric macules or flat atypical targets | |||
* Toxic Epidermal Necrolysis with Spots: Detachment above 30% of the body surface area plus widespread purpuric macules or flat atypical targets | |||
* Toxic Epidermal Necrolysis without Spots: Detachment above 10% of the body surface area with large epidermal sheets and without any purpuric macule or target | |||
* | |||
* | |||
==References== | ==References== | ||
Latest revision as of 21:09, 10 September 2018
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Stevens-Johnson syndrome Microchapters |
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Differentiating Stevens-Johnson Syndrome from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Stevens-Johnson syndrome classification On the Web |
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American Roentgen Ray Society Images of Stevens-Johnson syndrome classification |
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Risk calculators and risk factors for Stevens-Johnson syndrome classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anila Hussain, MD [2]
Overview
There is agreement in the medical literature that Stevens-Johnson syndrome can be considered a milder form of toxic epidermal necrolysis (TEN). Stevens-Johnson Syndrome involves less than 10 percent of body surface area while TEN involve more than 30 percent body surface area. However, there is debate whether it falls on a spectrum of disease that includes erythema multiforme and erythema multiforme major (also known as erythema multiforme majus).[1][2][3][4][5]
Classification
Skin lesions can be classified into 5 Different Categories as defined below[6]:
- Bullous Eythema Multiforme: Detachment below 10% of the body surface area (BSA) plus localized typical targets or raised atypical targets
- Stevens-Johnson Syndrome: Detachment below 10% of the body surface area plus widespread erythematous or purpuric macules or flat atypical targets
- Stevens-Johnson and Toxic Epidermal Necrolysis Overlap: Detachment between 10% and 30% of the body surface area plus widespread purpuric macules or flat atypical targets
- Toxic Epidermal Necrolysis with Spots: Detachment above 30% of the body surface area plus widespread purpuric macules or flat atypical targets
- Toxic Epidermal Necrolysis without Spots: Detachment above 10% of the body surface area with large epidermal sheets and without any purpuric macule or target
References
- ↑ Carrozzo M, Togliatto M, Gandolfo S (1999). "[Erythema multiforme. A heterogeneous pathologic phenotype]". Minerva Stomatol. 48 (5): 217–26. PMID 10434539.
- ↑ Farthing P, Bagan J, Scully C (2005). "Mucosal disease series. Number IV. Erythema multiforme". Oral Dis. 11 (5): 261–7. PMID 16120111.
- ↑ Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC (1993). "Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme". Archives of dermatology. 129 (1): 92–6. doi:10.1001/archderm.129.1.92. PMID 8420497.
- ↑ Ogundele O, Silverberg MA. Erythema Multiforme. eMedicine.com. URL: http://www.emedicine.com/emerg/topic173.htm. Accessed on: May 6, 2007.
- ↑ Auquier-Dunant A, Mockenhaupt M, Naldi L, Correia O, Schröder W, Roujeau JC (2002). "Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study". Arch Dermatol. 138 (8): 1019–24. PMID 12164739. Unknown parameter
|month=ignored (help) - ↑ Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC (1993). "Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme". Arch Dermatol. 129 (1): 92–6. PMID 8420497.