Table 1.

Key differences among the types of severe rash.

	TEN	EM	SSSS	AGEP	DRESS
Favorite group	Adult	Children and young women	Infant, occasionally in adults	Adult	Adult
Common causes	Drugs, infections	Infections, drugs, and diseases	Staphylococcus aureus	Antibacterial drugs (β-lactam, macrolides), nonsteroidal anti-inflammatory Drugs.	Medication, human herpesvirus 6
common symptom	Fatigue, chills, myalgia, and fever	Headache, fever, joint and muscle aches, tonsillitis, and respiratory infections;	Impetigo, scalded bulla, exfoliation of large epidermis	The appearance of non-follicular sterile pustules is preceded by erythema, often accompanied by fever and other symptoms.	The clinical manifestations are diverse, with a long incubation period (2–8 weeks), often manifested as fever, lymph node enlargement, increased eosinophils, and multiple organ damage
Characteristics of rash	Painful local erythema that spreads quickly with a loose bulla or peeling of the epidermis on the erythema. Extensive peeling, extensive erosion, including all mucous membranes (eyes, mouth, external genitals) if lightly touched or pulled	The rashes are polymorphic, with erythema, papules, wind masses, blisters, bullosa and purpura, etc. The rashes of this disease are polymorphic, with typical target-shaped lesions, which tend to occur at the extremities, symmetrical distribution, mucosal lesions, and systemic symptoms, such as fever in severe cases	The disease appears suddenly, with erythema occurring around the mouth or eyelids at first, and then rapidly spreading to the trunk and proximal limbs, or even generalized throughout the body, with obvious pain at the lesions. Laxative bullae occur based on erythema, and exudation and scabs occur around the mouth and eyelids within 1 to 2 days, with large areas of scabs falling off, leaving radiating clefts around the mouth.	The rash typically initiates on the facial area and in skin folds, such as the neck, armpits, groin, etc., and rapidly disseminates to encompass a large portion of the skin within a short timeframe. The rash presents as superficial sterile pustules, small and densely distributed, accompanied by a certain burning or itching sensation.	Facial edema, rapidly affecting erythema and papules throughout the body, can also manifest as purpura, exfoliative dermatitis, etc.
Treatment	Cyclosporin A, gamma globulin, glucocorticoid	Etiological treatment	Adequate and effective antibiotics should be used in the early stages	Discontinue suspicious drugs and use glucocorticoid	Discontinue suspicious drugs and use glucocorticoid

TEN, toxic epidermal necrolysis; EM, erythema multiforme; SSSS, staphylococcal scalded skin syndrome; AGEP, acute generalized exanthematous pustulosis; DRESS, drug rash with eosinophilia and systemic symptoms.