Prognosis

SJS-TEN is an acute self-limiting disease, with high morbidity and is potentially life-threatening. Mortality rates are 5% with SJS, 30-35% with

TEN and 10-15% with transitional forms. Epidermal detachment may be extensive, possibly the entire skin surface. As in severe burns, fluid losses are massive, with electrolyte imbalance. Superinfection, impairment of thermoregulation, energy expenditure, alteration of immunological function and haematological abnormalities are usual systemic complications. Mucous membrane involvement (oropharynx, eyes, genitalia and anus) require attentive nursing. The gastrointestinal and tracheobronchial epithelia can be involved and cause high morbidity.

Age, percentage of denuded skin, neutropenia, serum urea nitrogen level and visceral involvement are prognostic factors. There are different scoring systems for vital prognosis estimation, such as simplified acute physiology score (SAPS) and SAPS II, which are not specific. A new score - SCORTEN - has been proposed as a TEN-specific severity-of-illness score and validated in a single centre.5

After healing, scars, pigmentation disorders, conjunctival lesions and Sjogren-like syndrome are the main long-term complications.

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