SJS/TEN has rarely been associated with vaccination and infections such as mycoplasma and cytomegalovirus. Infections are generally associated with mucosal involvement and less severe cutaneous disease than when drugs are the cause. Roujeau J-C. Clinical heterogeneity of drug hypersensitivity. Toxicology 2005; 209: 123–129. PubMed. SJS/TEN is suspected clinically and classified based on the skin surface area detached at maximum extent.

Hospital admission — preferably immediately to an intensive care and burns unit with specialist nursing care, as this improves survival, reduces infection and shortens hospital stayMeth MJ, Sperber KE. Phenotypic diversity in delayed drug hypersensitivity: An immunologic explanation. Mount Sinai Journal of Medicine 2006; 73: 769–76. PubMed. Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are now believed to be variants of the same condition, distinct from erythema multiforme. SJS/TEN is a rare, acute, serious, and potentially fatal skin reaction in which there are sheet-like skin and mucosal loss. Using current definitions, it is nearly always caused by medications. Who gets SJS/TEN? Thalidomide, trialled because of its anti-TNFα effect, increased mortality, and should not be used. How can SJS/TEN be prevented?

The category cannot always be defined with certainty on initial presentation. The diagnosis may, therefore, change during the first few days in the hospital. Investigations in SJS/TEN The best PC case will simplify the building process, while a bad case limits your expandability options or makes it difficult to build your machine. If building a PC seems a little out of your comfort zone in general, you can always go with a prebuilt gaming PC and skip the stress of building your own.Your choice of PC case will also dictate what can go inside. If you want multi-loop liquid cooling and the biggest GPUs on the planet, then your best bet is a full-tower chassis. But if you're looking for a small-scale build, then the best mini-ITX cases will be what you covet. Wolf R, Orion E, Marcos B, Matz H. Life-threatening acute adverse cutaneous drug reactions. Clinics in Dermatology 2005; 23; 171–81. PubMed.

If ulcerated, prevent vaginal adhesions using intravaginal steroid ointment, soft vaginal dilators. If the test is available, elevated levels of serum granulysin taken in the first few days of a drug eruption may be predictive of SJS/TEN.

Sign up to the newsletter

Avoid using adhesive tapes and unnecessary removal of dead skin; leave the blister roof as a ‘biological dressing’. People who have survived SJS/TEN must be educated to avoid taking the causative drug or structurally related medicines as SJS/TEN may recur. Cross-reactions can occur between: Dressings such as gauze with petrolatum, non-adherent nanocrystalline-containing silver gauze or biosynthetic skin substitutes such as Biobrane® can reduce pain. Which you'll still be able to show off because you get a full height acrylic side panel—though you can buy a more expensive tempered glass version—that gives you a great view of your gaming rig's innards. SJS/TEN is a very rare complication of medication use (estimated at 1–2/million each year for SJS, and 0.4–1.2/million each year for TEN).