Wound Management in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Purpose of Review: Stevens-Johnson syndrome and toxic epidermal necrolysis are severe mucocutaneous drug reactions associated with a potentially high mortality rate. They are characterized by epidermal necrosis and extensive detachment. For these reasons, wound care is a fundamental component of patient management. However, there is a lack of evidence-based data, and treatment approaches can vary drastically between institutions. Our aim was to analyze the available studies on this topic as an attempt to review various management strategies. Recent Findings: Considering the rarity, variable presentations, and difficulty to prospectively study patients with SJS/TEN, there is a lack of evidence-based data on the topic of wound management. We reviewed the most recently published guidelines, expert opinions, and other studies from different countries and hospital centers. Summary: There is a great variability in the utilization of antiseptic agents, wound dressing types, and implementation of surgical debridement across the globe and different institutions. There is a lack of randomized controlled trials. However, the general principle is to protect the underlying viable exposed dermis, minimize the risk of infection, reduce the risk of pigmentary changes and scarring, and optimize the conditions for re-epithelization. Large-scale randomized clinical trials are needed for the optimization of wound care in these conditions.