Latin American guidelines for the diagnosis and treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis.

BACKGROUND

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.

OBJECTIVE

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.

METHODS

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.

RESULTS

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.