Weinkle et al reported a model for distinguishing a patient with Stevens Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN) from other skin conditions. The authors are from the University of South Florida, Ohio State University, University of Alabama, and the Oregon Health and Science University.
Skin conditions that may mimic Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis:
(1) drug hypersensitivity syndrome
(2) morbilliform drug eruption
(3) erythema multiforme
(4) acute generalized exanthematous pustulosis
Parameters:
(1) Nikolsky sign
(2) atypical target skin lesions (either (1) 2-zone flat or elevated targetoid lesions with poorly-defined borders with or without bulla or erosion; or (2) a macule with a central dusky, violaceous hue)
(3) fever
(4) lymphopenia
Parameter
Finding
Points
Nikolsky sign
no
0
yes
4.4
atypical targets
no
0
yes
3.8
fever
no
0
yes
2.1
lymphopenia
no
0
yes
1.9
total score =
= SUM(points for all of the parameters)
value of X =
= (total score) - 4.7
probability of SJS or TEN =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.96.
To read more or access our algorithms and calculators, please log in or register.
