Undiagnosed and Rare Diseases in Critical Care: Severe Mucocutaneous Medication Reactions

There have been major advances in the understanding of severe cutaneous adverse reactions (SCARs). Early recognition and withdrawal of culprit medications can decrease morbidity and mortality significantly. SCARs encompass a variety of entities that present with extensive mucocutaneous involvement and systemic symptoms, often requiring management in an intensive care setting. Physicians need to recognize SCARs early in their course, including drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome, and toxic epidermal necrolysis, and their mimicking conditions. This review focuses on common and rare SCARs with an emphasis on defining features, clinical and diagnostic evaluation, treatment, and long-term sequelae.