Stevens-Johnson syndrome classification

There is agreement in the medical literature that Stevens-Johnson syndrome can be considered a milder form of toxic epidermal necrolysis (TEN). Stevens-Johnson Syndrome involves less than 10 percent of body surface area while TEN involve more than 30 percent body surface area. However, there is debate whether it falls on a spectrum of disease that includes erythema multiforme and erythema multiforme major (also known as erythema multiforme majus).^{[1][2][3][4][5]}

Skin lesions can be classified into 5 Different Categories as defined below^[6]:

• Bullous Eythema Multiforme: Detachment below 10% of the body surface area (BSA) plus localized typical targets or raised atypical targets
• Stevens-Johnson Syndrome: Detachment below 10% of the body surface area plus widespread erythematous or purpuric macules or flat atypical targets
• Stevens-Johnson and Toxic Epidermal Necrolysis Overlap: Detachment between 10% and 30% of the body surface area plus widespread purpuric macules or flat atypical targets
• Toxic Epidermal Necrolysis with Spots: Detachment above 30% of the body surface area plus widespread purpuric macules or flat atypical targets
• Toxic Epidermal Necrolysis without Spots: Detachment above 10% of the body surface area with large epidermal sheets and without any purpuric macule or target

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