Abstract：
BACKGROUND: Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious conditions that carry a high rate of morbidity and mortality.
OBJECTIVE: This review highlights the pearls and pitfalls of SJS/TEN, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence.
CONCLUSIONS: SJS/TEN is a rare, delayed hypersensitivity reaction resulting in de-epithelialization of the skin and mucous membranes. The majority of cases are associated with medication or infection. Clinicians should consider SJS/TEN in any patient presenting with a blistering mucocutaneous eruption. Evaluation of the skin, mucosal, pulmonary, renal, genital, and ocular systems are essential in the diagnosis of SJS/TEN, as well as in the identification of complications (e.g., sepsis). Laboratory and radiological testing cannot confirm the diagnosis in the ED setting, but they may assist in the identification of complications. ED management includes stabilization of airway and breathing, fluid resuscitation, and treatment of any superimposed infections with broad-spectrum antibiotic therapy. All patients with suspected SJS/TEN should be transferred and admitted to a center with burn surgery, critical care, dermatology, and broad specialist availability.
CONCLUSIONS: An understanding of SJS/TEN can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
OBJECTIVE: This review highlights the pearls and pitfalls of SJS/TEN, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence.
CONCLUSIONS: SJS/TEN is a rare, delayed hypersensitivity reaction resulting in de-epithelialization of the skin and mucous membranes. The majority of cases are associated with medication or infection. Clinicians should consider SJS/TEN in any patient presenting with a blistering mucocutaneous eruption. Evaluation of the skin, mucosal, pulmonary, renal, genital, and ocular systems are essential in the diagnosis of SJS/TEN, as well as in the identification of complications (e.g., sepsis). Laboratory and radiological testing cannot confirm the diagnosis in the ED setting, but they may assist in the identification of complications. ED management includes stabilization of airway and breathing, fluid resuscitation, and treatment of any superimposed infections with broad-spectrum antibiotic therapy. All patients with suspected SJS/TEN should be transferred and admitted to a center with burn surgery, critical care, dermatology, and broad specialist availability.
CONCLUSIONS: An understanding of SJS/TEN can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
摘要：
背景：史蒂文斯·约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是严重的疾病，具有很高的发病率和死亡率。
目的：这篇综述突出了SJS/TEN的珍珠和陷阱，包括介绍,诊断,并根据当前证据对急诊科（ED）进行管理。
结论：SJS/TEN是一种罕见的，导致皮肤和粘膜去上皮化的迟发性超敏反应。大多数病例与药物治疗或感染有关。临床医生应考虑SJS/TEN在任何出现皮肤皮肤起泡的患者。评估皮肤，粘膜，肺,肾,生殖器,和眼部系统在SJS/TEN的诊断中至关重要，以及在并发症的识别中(例如，脓毒症)。实验室和放射学测试无法确认ED设置中的诊断，但它们可能有助于识别并发症。ED管理包括稳定气道和呼吸，液体复苏,以及用广谱抗生素疗法治疗任何叠加感染。所有疑似SJS/TEN的患者都应转移到烧伤手术中心，重症监护,皮肤病学,和广泛的专家可用性。
结论：了解SJS/TEN可以帮助急诊临床医生诊断和管理这种可能致命的疾病。
目的：这篇综述突出了SJS/TEN的珍珠和陷阱，包括介绍,诊断,并根据当前证据对急诊科（ED）进行管理。
结论：SJS/TEN是一种罕见的，导致皮肤和粘膜去上皮化的迟发性超敏反应。大多数病例与药物治疗或感染有关。临床医生应考虑SJS/TEN在任何出现皮肤皮肤起泡的患者。评估皮肤，粘膜，肺,肾,生殖器,和眼部系统在SJS/TEN的诊断中至关重要，以及在并发症的识别中(例如，脓毒症)。实验室和放射学测试无法确认ED设置中的诊断，但它们可能有助于识别并发症。ED管理包括稳定气道和呼吸，液体复苏,以及用广谱抗生素疗法治疗任何叠加感染。所有疑似SJS/TEN的患者都应转移到烧伤手术中心，重症监护,皮肤病学,和广泛的专家可用性。
结论：了解SJS/TEN可以帮助急诊临床医生诊断和管理这种可能致命的疾病。
