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Journal of the American Academy of Dermatology

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Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults - 20/04/20

Doi : 10.1016/j.jaad.2020.02.066 
Lucia Seminario-Vidal, MD, PhD a, b, ⁎ , Daniela Kroshinsky, MD, MPH c, ∗, Stephen J. Malachowski, MD, MS d, James Sun, MD b, Alina Markova, MD e, Thomas M. Beachkofsky, MD f, ∗, Benjamin H. Kaffenberger, MD g, ∗, Elizabeth N. Ergen, MD h, ∗, Melissa Mauskar, MD i, j, ∗, Alina Bridges, MD k, ∗, Cody Calhoun, BS g, Adela R. Cardones, MD l, ∗, Steven T. Chen, MD, MPH, MS-HPEd c, ∗, James Chodosh, MD, MPH m, Jonathan Cotliar, MD n, ∗, Mark D.P. Davis, MD k, ∗, Katherine L. DeNiro, MD o, ∗, Arturo R. Dominguez, MD i, ∗, Juliana Eljure-Téllez, MD p, Alisa Femia, MD q, ∗, Lindy P. Fox, MD r, ∗, Anisha Guda, BS s, Caroline Mitchell, MD, MPH t, Arash Mostaghimi, MD, MPA, MPH u, ∗, Alex G. Ortega-Loayza, MD v, ∗, Cindy Owen, MD w, ∗, Helena Pasieka, MD x, ∗, Sahand Rahnama-Moghadam, MD, MS y, ∗, Hajirah N. Saeed, MD m, Rebecca B. Saunderson, MD z, ∗, Swapna Shanbhag, MD aa, Victoria R. Sharon, MD, DTMH bb, ∗, Lindsay Strowd, MD cc, ∗, Samantha Venkatesh, MD dd, Karolyn A. Wanat, MD ee, ∗, David A. Wetter, MD k, ∗, Scott Worswick, MD ff, ∗, Robert G. Micheletti, MD gg, ∗
a Department of Dermatology, University of South Florida, Morsani College of Medicine, Tampa, Florida 
b Cutaneous Oncology Program, H. Lee Moffitt Cancer Center, Tampa, Florida 
c Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 
d Department of Internal Medicine, Medical College of Wisconsin Affiliated Hospitals, St. Joseph’s Hospital, Milwaukee, Wisconsin 
e Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 
f Department of Dermatology, Uniformed Services University, Bethesda, Maryland 
g Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio 
h Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama 
i Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas 
j Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas 
k Department of Dermatology, Mayo Clinic, Rochester, Minnesota 
l Department of Dermatology, Duke University, Durham, North Carolina 
m Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 
n Division of Dermatology, Harbor-University of California, Los Angeles Medical Center, Los Angeles, California 
o Division of Dermatology, University of Washington, Seattle, Washington 
p Department of Dermatology, “Dr. Manuel Gea González” General Hospital, Mexico City, Mexico 
q Ronald O. Perelman Department of Dermatology, New York University Langone Health, New York, New York 
r Department of Dermatology, University of California, San Francisco, California 
s University of Texas Health San Antonio Long School of Medicine, San Antonio, Texas 
t Vincent Center for Reproductive Biology, Department of Obstetrics, Gynecology & Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts 
u Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 
v Department of Dermatology, Oregon Health and Science University, Portland, Oregon 
w Division of Dermatology, Department of Medicine, University of Louisville, Louisville, Kentucky 
x Department of Dermatology, MedStar Washington Hospital Center, Washington, DC 
y Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana 
z Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia 
aa Tej Kohli Cornea Institute, L.V. Prasad Eye Institute, Hyderabad, India 
bb Department of Dermatology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York 
cc Department of Dermatology, Wake Forest University School of Medicine, Wake Forest, North Carolina 
dd Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 
ee Department of Dermatology, University of Southern California, Los Angeles, California 
ff Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin 
gg Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania 

∗Correspondence to: Lucia Seminario-Vidal, MD, PhD, 13330 USF Laurel Dr, 6th Floor, Tampa, FL 33612.13330 USF Laurel Dr, 6th FloorTampaFL33612
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Monday 20 April 2020

Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening conditions with high morbidity and mortality. Supportive care management of SJS/TEN is highly variable. A systematic review of the literature was performed by dermatologists, ophthalmologists, intensivists, and gynecologists with expertise in SJS/TEN to generate statements for supportive care guideline development. Members of the Society of Dermatology Hospitalists with expertise in SJS/TEN were invited to participate in a modified, online Delphi-consensus. Participants were administered 9-point Likert scale questionnaires regarding 135 statements. The RAND/UCLA Appropriateness Method was used to evaluate and select proposed statements for guideline inclusion; statements with median ratings of 6.5 to 9 and a disagreement index of ≤1 were included in the guideline. For the final round, the guidelines were appraised by all of the participants. Included are an evidence-based discussion and recommendations for hospital setting and care team, wound care, ocular care, oral care, urogenital care, pain management, infection surveillance, fluid and electrolyte management, nutrition and stress ulcer prophylaxis, airway management, and anticoagulation in adult patients with SJS/TEN.

Le texte complet de cet article est disponible en PDF.

Key words : dermatology consultation, inpatient, severe cutaneous adverse reaction, Society of Dermatology Hospitalists, Stevens-Johnson syndrome, toxic epidermal necrolysis

Abbreviations used : AT, DI, ICU, SDH, SJS, TEN


Plan


 Funding sources: None.
 Conflicts of interest: None disclosed.
 IRB approval status: Not applicable.
 Reprints not available from the authors.


© 2020  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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