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Síndrome de Stevens-Johnson y necrólisis epidérmica tóxica

Last reviewed: 20 Aug 2025
Last updated: 01 Dec 2022

Summary

Definição

História e exame físico

Principais fatores diagnósticos

  • presencia de factores de riesgo
  • erupción
  • afectación de la mucosa
  • signo de Nikolsky
  • ampollas
Detalhes completos

Fatores de risco

  • pacientes con cáncer activo
  • medicamentos anticonvulsivos
  • infección reciente
  • uso reciente de antibióticos
  • otros medicamentos
  • lupus eritematoso sistémico
  • Pacientes infectados por el VIH
  • radioterapia
  • antígeno leucocitario humano y predisposición genética
  • vacunación contra la viruela
  • trasplante de médula ósea
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • biopsia de piel
  • hemocultivos
  • hemograma completo
  • glucosa
  • magnesio
  • fosfato
  • urea
  • bicarbonato
  • electrolitos séricos
  • creatinina sérica
  • pruebas de función hepática
  • velocidad de sedimentación globular
  • proteína C-reactiva
  • gasometría arterial y saturación de oxígeno
  • radiografía de tórax
  • estudios de coagulación
  • hisopo de piel lesionada
  • Serología de micoplasma
Detalhes completos

Investigações a serem consideradas

  • inmunofluorescencia directa
Detalhes completos

Algoritmo de tratamento

AGUDA

todos los pacientes

Colaboradores

Autores

Areta Kowal-Vern, MD

Adjunct Research Faculty

Arizona Burn Center

Valleywise Health Medical Center

Phoenix

AZ

Declarações

AK-V performs occasional manuscript reviews on various topics for Research Square, Inc. and the Journal of Burn Care and Research in the US for which she receives a nominal monetary fee. AK-V is an author of a reference cited in this topic.

Revisores

Barbara A. Latenser, MD

Director Burn Unit

Department of Surgery

University of Iowa Hospitals

Iowa City

IA

Declarações

BAL declares that she has no competing interests.

Tina Palmieri, MD

Assistant Chief of Burns

Shriners Hospital

UC Davis

Sacramento

CA

Declarações

TP declares that she has no competing interests.

Venkat Gudi, MB BS

Consultant Dermatologist

Department of Dermatology

West Suffolk Hospital

Bury St. Edmunds

UK

Declarações

VG declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Bastuji-Garin S, Rzany B, Stern RS, et al. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. Arch Dermatol. 1993 Jan;129(1):92-6. Resumo

Creamer D, Walsh SA, Dziewulski P, et al. UK guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults 2016. Br J Dermatol. 2016 Jun;174(6):1194-227.Texto completo  Resumo

Seminario-Vidal L, Kroshinsky D, Malachowski SJ, et al. Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults. J Am Acad Dermatol. 2020 Jun;82(6):1553-67. Resumo

Gregory DG. New grading system and treatment guidelines for the acute ocular manifestations of Stevens-Johnson syndrome. Ophthalmology. 2016 Aug;123(8):1653-8. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Síndrome de Stevens-Johnson y necrólisis epidérmica tóxica images
  • Diagnósticos diferenciais

    • Erupción por fármacos con eosinofilia y síntomas sistémicos (DRESS)
    • Dermatitis exfoliativa estafilocócica
    • Síndrome de shock tóxico
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults
    • Management of Stevens-Johnson syndrome/toxic epidermal necrolysis in children and young people (0 to 17 years)
    Mais Diretrizes
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