Burn unit care of Stevens Johnson syndrome/toxic epidermal necrolysis: A survey

Hong-Gam Le; Hajirah Saeed; Iason S Mantagos; Caroline M Mitchell; Jeremy Goverman; James Chodosh

doi:10.1016/j.burns.2015.12.001

Burn unit care of Stevens Johnson syndrome/toxic epidermal necrolysis: A survey

Burns. 2016 Jun;42(4):830-5. doi: 10.1016/j.burns.2015.12.001. Epub 2016 Jan 19.

Authors

Hong-Gam Le¹, Hajirah Saeed², Iason S Mantagos³, Caroline M Mitchell⁴, Jeremy Goverman⁵, James Chodosh⁶

Affiliations

¹ University of Michigan Medical School, 1125 Freesia Street, Ann Arbor, MI 48105, USA. Electronic address: hgle@med.umich.edu.
² Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. Electronic address: Hajirah_Saeed@meei.harvard.edu.
³ Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA. Electronic address: Jason.Mantagos@childrens.harvard.edu.
⁴ Department of Obstetrics and Gynecology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. Electronic address: Caroline.Mitchell@mgh.harvard.edu.
⁵ Division of Burns, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. Electronic address: JGoverman@mgh.harvard.edu.
⁶ Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA. Electronic address: James_Chodosh@meei.harvard.edu.

PMID: 26810444
DOI: 10.1016/j.burns.2015.12.001

Abstract

Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a systemic disease that can be associated with debilitating acute and chronic complications across multiple organ systems. As patients with acute SJS/TEN are often treated in a burn intensive care unit (BICU), we surveyed burn centers across the United States to determine their approach to the care of these patients. The goal of our study was to identify best practices and possible variations in the care of patients with acute SJS/TEN. We demonstrate that the method of diagnosis, use of systemic therapies, and involvement of subspecialists varied significantly between burn centers. Beyond supportive care provided to every patient, our data highlights a lack of standardization in the acute care of patients with SJS/TEN. A comprehensive guideline for the care of patients with acute SJS/TEN is indicated.

Keywords: Burn intensive care unit; Stevens-Johnson syndrome; Survey; Toxic epidermal necrolysis.

MeSH terms

Acute Disease
Adult
Burn Units*
Child
Delivery of Health Care, Integrated / standards*
Female
Healthcare Disparities
Humans
Intensive Care Units*
Male
Patient Education as Topic / standards
Stevens-Johnson Syndrome / diagnosis
Stevens-Johnson Syndrome / therapy*
United States