Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

Lucia Seminario-Vidal, Daniela Kroshinsky, Stephen J. Malachowski, James Sun, Alina Markova, Thomas M. Beachkofsky, Benjamin H. Kaffenberger, Elizabeth N. Ergen, Melissa Mauskar, Alina Bridges, Cody Calhoun, Adela R. Cardones, Steven T. Chen, James Chodosh, Jonathan Cotliar, Mark D.P. Davis, Katherine L. DeNiro, Arturo R. Dominguez, Juliana Eljure-Téllez, Alisa FemiaLindy P. Fox, Anisha Guda, Caroline Mitchell, Arash Mostaghimi, Alex G. Ortega-Loayza, Cindy Owen, Helena Pasieka, Sahand Rahnama-Moghadam, Hajirah N. Saeed, Rebecca B. Saunderson, Swapna Shanbhag, Victoria R. Sharon, Lindsay Strowd, Samantha Venkatesh, Karolyn A. Wanat, David A. Wetter, Scott Worswick, Robert G. Micheletti

Research output: Contribution to journalArticle

Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening conditions with high morbidity and mortality. Supportive care management of SJS/TEN is highly variable. A systematic review of the literature was performed by dermatologists, ophthalmologists, intensivists, and gynecologists with expertise in SJS/TEN to generate statements for supportive care guideline development. Members of the Society of Dermatology Hospitalists with expertise in SJS/TEN were invited to participate in a modified, online Delphi-consensus. Participants were administered 9-point Likert scale questionnaires regarding 135 statements. The RAND/UCLA Appropriateness Method was used to evaluate and select proposed statements for guideline inclusion; statements with median ratings of 6.5 to 9 and a disagreement index of ≤1 were included in the guideline. For the final round, the guidelines were appraised by all of the participants. Included are an evidence-based discussion and recommendations for hospital setting and care team, wound care, ocular care, oral care, urogenital care, pain management, infection surveillance, fluid and electrolyte management, nutrition and stress ulcer prophylaxis, airway management, and anticoagulation in adult patients with SJS/TEN.

Original languageEnglish (US)
Pages (from-to)1553-1567
Number of pages15
JournalJournal of the American Academy of Dermatology
Volume82
Issue number6
DOIs
StatePublished - Jun 2020

Keywords

  • Society of Dermatology Hospitalists
  • Stevens-Johnson syndrome
  • dermatology consultation
  • inpatient
  • severe cutaneous adverse reaction
  • toxic epidermal necrolysis

ASJC Scopus subject areas

  • Dermatology

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    Seminario-Vidal, L., Kroshinsky, D., Malachowski, S. J., Sun, J., Markova, A., Beachkofsky, T. M., Kaffenberger, B. H., Ergen, E. N., Mauskar, M., Bridges, A., Calhoun, C., Cardones, A. R., Chen, S. T., Chodosh, J., Cotliar, J., Davis, M. D. P., DeNiro, K. L., Dominguez, A. R., Eljure-Téllez, J., ... Micheletti, R. G. (2020). Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults. Journal of the American Academy of Dermatology, 82(6), 1553-1567. https://doi.org/10.1016/j.jaad.2020.02.066