Table 5.

Key points discussed during “updates for clinicians.”

Specialized units Consideration should be made to transfer patients with suspected SJS/TEN to hospitals with dermatology inpatient wards or burn centers early in their presentation. The decision should be based on the extent of skin detachment and the need for intensive care. Acute and critical care needs for patients with SJS/TEN can be similar to those of patients suffering a thermal injury. Psychosocial, rehabilitation, and after care needs for patients with SJS/TEN might be better addressed at hospitals with established programs for patients recovering from thermal injury. Eye care Early ocular involvement is highly variable and can result in chronic complications leading to severe ocular surface disease including corneal blindness. Patients who receive acute ophthalmic care based on an evidence-based treatment that involves the use of amniotic membrane may be more likely to retain >20/40 vision than those who do not. Customized scleral lenses provide a protective barrier, support the ocular surface, and can prevent corneal complications, improving visual acuity and comfort. Genitourinary issues Gynecology was only consulted in half of the cases of possible vulvovaginal involvement. There appeared to be an assumption that there was no need for vulvovaginal care in patients presumably not sexually active. Obtaining consent in a sensitive matter is important in very young/older patients as to explain long-term sequelae. Unusual presentations Recognition of SJS/TEN mimickers is critical as management and prognosis can be very different for each category. These include infectious, autoimmune, reactive, and other drug response etiologies. Autoimmune conditions and reactive conditions can produce cutaneous mimics of SJS/TEN but differences exist in presentation, chronicity, laboratory studies and histopathology. While greater than 85% of patients will present with involvement of two mucosal sites some patients have a delayed second mucosal site involvement. Often times this 2nd site includes ocular mucosa.