Murillo-Casas Andrea Dionelly, Zwiener Ricardo, Giavina-Bianchi Pedro, Pardo-Manrique Verónica, Villarreal-González Rosalaura, Monge-Ortega Olga Patricia, Velásquez-Lopera Margarita María, Silva-Espinosa Diana Lucia, Castillo-Loaiza Silvana Marcela, Muñoz-García Liliana Eugenia, Garzón-Portilla Maria Camila, León-Hernández Yury Juliana, Serrano-Reyes Carlos Daniel
Allergy Unit, Fundación Valle del Lili, Cali, Colombia.
School of Medicine, Universidad Icesi, Cali, Colombia.
World Allergy Organ J. 2025 Mar 26;18(4):101046. doi: 10.1016/j.waojou.2025.101046. eCollection 2025 Apr.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous reactions induced by delayed drug hypersensitivity, characterized by their complexity and multisystemic nature. Their diagnosis and management are challenging and require a multidisciplinary approach. Identifying the culprit drug is crucial to ensure that the patient has access to safe therapeutic options in the future. To date, there are no specific Latin American guideline or consensus documents on SJS/TEN.
To develop a Latin American guideline on the clinical diagnosis, management, and treatment of SJS/TEN, based on available scientific evidence and the experience of experts from various medical specialties.
This guideline was developed by a group of Latin American allergists and dermatologists involved in the management of SJS/TEN. A search of scientific publications was conducted, and the expert group evaluated the available evidence in the literature, providing grades of recommendation. In cases where there was insufficient evidence, consensus was reached among the experts.
The Latin American guidelines on SJS/TEN were developed, addressing relevant practical aspects of clinical diagnosis, and the identification of culprit drugs using the ALDEN (Algorithm of Drug Causality for Epidermal Necrolysis). It also offers recommendations on management, treatment, and prevention of complications, along with a specific algorithm for disease management. This guideline includes a therapeutic strategy, developed and agreed upon by expert specialists involved in the treatment of SJS/TEN.
史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是由药物迟发型超敏反应引起的严重皮肤反应，其特点是病情复杂且累及多系统。它们的诊断和管理具有挑战性，需要多学科方法。确定致病药物对于确保患者未来能够获得安全的治疗选择至关重要。迄今为止，拉丁美洲尚无关于SJS/TEN的具体指南或共识文件。
基于现有科学证据和各医学专科专家的经验，制定拉丁美洲关于SJS/TEN临床诊断、管理和治疗的指南。
本指南由一组参与SJS/TEN管理的拉丁美洲过敏症专科医生和皮肤科医生制定。对科学出版物进行了检索，专家组评估了文献中的现有证据，并给出推荐等级。在证据不足的情况下，专家们达成了共识。
制定了拉丁美洲关于SJS/TEN的指南，涉及临床诊断的相关实际方面，以及使用ALDEN（表皮坏死松解症药物因果关系算法）识别致病药物。它还提供了关于管理、治疗和预防并发症的建议，以及疾病管理的具体算法。本指南包括一种治疗策略，由参与SJS/TEN治疗的专家制定并达成一致。
