Stevens-Johnson syndrome and toxic epidermal necrolysis

Since their first descriptions in 1922 and 1948, respectively, Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) have become recognized as manifestations--with different severity--of the same disease process along a spectrum of illness. Even today, decades after their description, there is still disagreement about when a particular bullous disease evolves from erythema multiforme to SJS/TEN. There is no disagreement, however, about the potentially life-threatening nature of the disease. Many cases are misdiagnosed, especially in their early stages. In this paper we address our current understanding of this disease spectrum and discuss both accepted and more controversial modes of therapy.