Ellender Ryan P, Peters Cacey W, Albritton Hannah L, Garcia Andrew J, Kaye Alan David
Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA.
Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA ; School of Pharmacy, University of Arizona, Tucson, AZ.
Ochsner J. 2014 Fall;14(3):413-7.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered a spectrum of acute life-threatening mucocutaneous reactions that differ only in severity. Both diseases are characterized by mucous membrane and skin involvement, are often caused by medications, and are collectively known as epidermal necrolysis (EN).
A severity of illness score has been devised to predict prognosis in patients with EN. The scoring system addresses 7 prognostic factors.
Patients with EN require supportive care. Those with extensive skin involvement should be admitted to an intensive care unit or burn unit if possible. Suspected, as well as unnecessary, medications should be discontinued. Baseline laboratory tests, imaging, cultures, and biopsies should be obtained. Intravenous access should be established and hydration and nutritional support begun. Daily oral care, wound care, pain control, and early physician consultation are also important aspects of treatment.
EN requires early diagnosis, appropriate workup, and appropriate treatment to minimize potential morbidity and mortality. In many clinicians' experience, EN is rare; therefore, education and improved understanding of the potential causes and appropriate treatment regimens are vital when confronted with such a patient.
史蒂文斯 - 约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）被认为是一系列急性危及生命的黏膜皮肤反应，仅在严重程度上有所不同。这两种疾病均以黏膜和皮肤受累为特征，常由药物引起，统称为表皮坏死松解症（EN）。
已设计出一种疾病严重程度评分系统来预测EN患者的预后。该评分系统涉及7个预后因素。
EN患者需要支持性治疗。皮肤广泛受累的患者应尽可能收入重症监护病房或烧伤病房。应停用可疑以及不必要的药物。应进行基线实验室检查、影像学检查、培养和活检。应建立静脉通路并开始补液和营养支持。每日口腔护理、伤口护理、疼痛控制以及早期咨询医生也是治疗的重要方面。
EN需要早期诊断、适当的检查和适当的治疗，以尽量降低潜在的发病率和死亡率。根据许多临床医生的经验，EN很罕见；因此，在面对此类患者时，对潜在病因和适当治疗方案的教育及更好的理解至关重要。
