electrolytes in SJS/TEN

 Q: Which two electrolytes are considered a good marker of disease severity in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)? 

Answer: Serum urea nitrogen and glucose

Contrary to popular belief, eosinophilia is unusual in SJS/TEN. Neutropenia is considered a marker for poor prognosis but it is hard to predict as the administration of steroids obscure neutropenia due to demarginalization and mobilization of neutrophils into the circulation. 

 When it comes to electrolytes, serum urea nitrogen above 28 mg/dL and glucose above 250 mg/dL are considered good markers of disease severity.

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References:

1. Westly ED, Wechsler HL. Toxic epidermal necrolysis. Granulocytic leukopenia as a prognostic indicator. Arch Dermatol 1984; 120:721. 

2. Bastuji-Garin S, Fouchard N, Bertocchi M, et al. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol 2000; 115:149.