Merck Manual

Please confirm that you are not located inside the Russian Federation

Yes No

Leave this Site?

The link you have selected will take you to a third-party website. We do not control or have responsibility for the content of any third-party site.

Continue Cancel
honeypot link
Merck Manual
Consumer Version
The trusted provider of medical information since 1899
Health Topics & Chapters
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Home /
Quick Facts: Skin Disorders /
Hypersensitivity and Inflammatory Skin Disorders /
... /
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) /
IN THIS TOPIC

What are Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)?

What causes SJS and TEN?

What are the symptoms of SJS and TEN?

How can doctors tell if I have SJS or TEN?

How do doctors treat SJS and TEN?

OTHER TOPICS IN THIS CHAPTER

Hypersensitivity and Inflammatory Skin Disorders
Drug Rashes
Erythema Multiforme
Erythema Nodosum
Granuloma Annulare
Keratosis Pilaris
Panniculitis
Pyoderma Gangrenosum
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)

ADDITIONAL CONTENT

Test your knowledge

Orbital Cellulitis
Which form of treatment may be necessary for orbital cellulitis but not for preseptal cellulitis? 
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID

More Content

Quick Facts

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)

By

The Manual's Editorial Staff

Last full review/revision Jan 2021| Content last modified Jan 2021
Click here for the Professional Version
Get the full details
Topic Resources

What are Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)?

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are forms of the same life-threatening skin disease. SJS involves less of your body, and TEN involves more. They both cause a rash, skin peeling, and sores.

  • SJS and TEN are usually caused by a reaction to a medicine

  • Symptoms for both diseases include peeling skin, fever, body aches, a flat red rash, and blisters and sores on your mouth, eyes, and vagina

  • Treatment is in an intensive care unit in the hospital and includes fluids, medicines, and stopping any medicine that may have caused the disease

What causes SJS and TEN?

SJS and TEN are most often caused by:

  • A reaction to a medicine, most often sulfa and other antibiotics or drugs for seizures (anticonvulsants)

Less often, cases are caused by a bacterial infection or vaccination.

SJS and TEN are more common in people who have:

What are the symptoms of SJS and TEN?

Symptoms of SJS and TEN usually start 1 to 3 weeks after starting a medicine. The first symptoms include:

  • Fever

  • Headache

  • Cough

  • Inflamed, red eyes

  • Body aches

Later symptoms include:

  • Flat, red rash on your face, neck, and trunk, which spreads to the rest of your body

  • Blisters that form and peel easily

  • Blistering in your mouth, eyes, and vagina

In SJS, skin peels off small areas of your body. In TEN, the areas are larger and more of your skin is affected. The more skin that peels off, the more dangerous it is.

How can doctors tell if I have SJS or TEN?

Doctors can tell you have SJS or TEN by asking you about your symptoms and looking at your skin. They may also do a skin biopsy (taking a little piece of tissue to look at under a microscope).

How do doctors treat SJS and TEN?

Doctors care for you in the hospital in an ICU (intensive care unit). Doctors will stop any medicines that might have caused your SJS or TEN.

Treatments include:

  • Fluids by vein

  • Plasma exchange (a process that lets doctors filter some substances, such as a medicine that's causing your reaction, out of your blood)

  • Immune globulin

  • Sometimes, medicine

Drugs Mentioned In This Article

Generic Name Select Brand Names
Immune globulin
 Gammagard S/D
NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
© 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA)
Pyoderma Gangrenosum
Others also read
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)
Overview of the Kidneys and Urinary Tract Overview of the Kidneys and Urinary Tract
Overview of Chromosomal Deletion Syndromes Overview of Chromosomal Deletion Syndromes

Also of Interest

SOCIAL MEDIA

Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID

Merck and the Merck Manuals

Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The Merck Manual was first published in 1899 as a service to the community. The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America. Learn more about our commitment to Global Medical Knowledge.

View Privacy Shield Verification Status
View APEC CBPR Privacy Certification Status

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.

© 2021 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA
TOP