Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

A painful, dusky eruption with fever after a new medication should be treated differently from an uncomplicated exanthem. In SJS/TEN, keratinocytes are dying across the epidermis; the skin barrier can fail quickly, and erosions may involve the mouth, eyes, genitals, or airway. The RN’s first clinical move is to stop further exposure to non-essential suspected drugs through the applicable order or urgent prescriber direction, then assess airway, circulation, fluid loss, pain, and mucosal injury. A biopsy and severity score refine the diagnosis and prognosis, but neither should delay stabilization, specialty consultation, or transfer when red flags are present.