Unravelling Stevens-Johnson Syndrome: Clinicopathological Insights and Therapeutic Advances.

Abstract

Introduction: Stevens-Johnson syndrome and Toxic Epidermal Necrolysis are a group of immunologically driven, multisystemic and dermatological blistering diseases. Certain classes of drugs and occasional viral infections are usually the inciting factors. The clinical presentation is generally nonspecific and can progress to severe ocular and vision-threatening complications, with prognosis depending upon several factors. Several grading systems exist to assess the impact of the disease, both in the acute and chronic phases. Diagnosis can be made based on clinical history, examination, and a questionnaire-based approach involving different bodily systems.

Methods: A literature search was conducted using various relevant keywords across different electronic databases. A total of 83 articles were included in the study.

Results: This comprehensive review highlights the various aspects of Stevens-Johnson syndrome, including disease burden, etiopathogenesis, clinical presentation, disease grading, diagnosis, and management of both the acute and chronic phases.

Discussion: Timely management by a multidisciplinary team is required to prevent long-term complications. Amniotic membrane transplantation is beneficial in the acute phase, in conjunction with medications, and in the chronic phase for surgical interventions such as eyelid malposition, persistent corneal epithelial defects, and lid margin keratinisation. For end-stage disease, procedures such as eyelid surgeries, amniotic membrane transplantation, mucous membrane grafting, and keratoprosthesis can help in ocular salvage.