eyes in SJS and TEN

Q: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) usually do not have ocular involvement?

A) True

B) False

Answer: B

Most of the patients with SJS and TEN has ocular involvement mostly as conjunctivitis, corneal ulcer, anterior uveitis, panophthalmitis, pain, photophobia and purulent discharge. In severe cases bullae may form. Ocular severity in SJS/TEN is grade as

0 - no involvement

1 - conjunctival hyperemia

2 - ocular surface epithelial defect or pseudomembrane formation

3 - both ocular surface epithelial defect and pseudomembrane formation 

Although signs and symptoms are reversible but may take longer time to resolve.

#opthalmology

#dermatology

References:

1. Sekula P, Dunant A, Mockenhaupt M, et al. Comprehensive survival analysis of a cohort of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. J Invest Dermatol 2013; 133:1197.

2. Hsu DY, Brieva J, Silverberg NB, et al. Pediatric Stevens-Johnson syndrome and toxic epidermal necrolysis in the United States. J Am Acad Dermatol 2017; 76:811.

3. Mittmann N, Knowles SR, Koo M, et al. Incidence of toxic epidermal necrolysis and Stevens-Johnson Syndrome in an HIV cohort: an observational, retrospective case series study. Am J Clin Dermatol 2012; 13:49.