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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Stevens-Johnson syndrome classification

Introduction

Overview

Overview

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]

Classification

Classification

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
References

References

  1. ↑ Carrozzo M, Togliatto M, Gandolfo S (1999). “[Erythema multiforme. A heterogeneous pathologic phenotype]”. Minerva Stomatol. 48 (5): 217–26. PMID 10434539.
  2. ↑ Farthing P, Bagan J, Scully C (2005). “Mucosal disease series. Number IV. Erythema multiforme”. Oral Dis. 11 (5): 261–7. PMID 16120111.
  3. ↑ Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC (1993). “Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme”. Archives of dermatology. 129 (1): 92–6. doi:10.1001/archderm.129.1.92. PMID 8420497.
  4. ↑ Ogundele O, Silverberg MA. Erythema Multiforme. eMedicine.com. URL: http://www.emedicine.com/emerg/topic173.htm. Accessed on: May 6, 2007.
  5. ↑ Auquier-Dunant A, Mockenhaupt M, Naldi L, Correia O, Schröder W, Roujeau JC (2002). “Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study”. Arch Dermatol. 138 (8): 1019–24. PMID 12164739. Unknown parameter |month= ignored (help)
  6. ↑ Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau JC (1993). “Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme”. Arch Dermatol. 129 (1): 92–6. PMID 8420497.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anila Hussain, MD [2]