Stevens-Johnson Syndrome Basics

Fever, skin pain, a rapidly spreading dusky or targetoid eruption, blistering, and erosions of the mouth, eyes, or genitals should raise immediate concern for Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). This is not simply a medication rash: immune-mediated keratinocyte death strips away the epidermal barrier, causing fluid loss, impaired temperature control, pain, and portals for infection. The bedside priority is to identify and stop the suspected medication while arranging urgent transfer to an intensive-care or specialized burn centre. An RPN should activate the local emergency process, follow agency policy for holding the medication, notify the prescriber, document recent drug exposures, and provide ordered supportive care without waiting for confirmatory testing.