Academic Journal
Diagnosis and Management of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Pediatric Patients: A Systematic Review of Clinical Guidelines and Consensus Statements.
| Τίτλος: | Diagnosis and Management of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Pediatric Patients: A Systematic Review of Clinical Guidelines and Consensus Statements. |
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| Συγγραφείς: | Creighton R; Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., Gupta S; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada., Langille C; Faculty of Medicine, Division of Dermatology, Dalhousie University, Halifax, Nova Scotia, Canada., Sutherland A; Faculty of Medicine, Division of Dermatology, Dalhousie University, Halifax, Nova Scotia, Canada. |
| Πηγή: | Pediatric dermatology [Pediatr Dermatol] 2026 May-Jun; Vol. 43 (3), pp. 579-589. Date of Electronic Publication: 2026 Feb 16. |
| Τύπος έκδοσης: | Journal Article; Systematic Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley Country of Publication: United States NLM ID: 8406799 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-1470 (Electronic) Linking ISSN: 07368046 NLM ISO Abbreviation: Pediatr Dermatol Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2010->: Hoboken, NJ : Wiley Original Publication: [Boston, MA] : Blackwell Scientific Publications, [1983- |
| Ιατρικοί όροι (MeSH): | Stevens-Johnson Syndrome*/diagnosis , Stevens-Johnson Syndrome*/therapy , Consensus Statements as Topic* , Practice Guidelines as Topic*, Child ; Humans ; Consensus |
| Περίληψη: | Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, life-threatening mucocutaneous reactions. Pediatric mortality is lower than in adults, but children face higher risks of recurrence and long-term sequelae. Despite disease severity, pediatric-specific guidelines remain scarce and often extrapolated from adult populations. We systematically reviewed and appraised national and international clinical practice guidelines and consensus statements on pediatric SJS/TEN, focusing on supportive care, pharmacologic interventions, mucosal management, and long-term follow-up. A systematic search of MEDLINE, Embase, PubMed, CENTRAL, Scopus, and CINAHL (January 2000-April 2025) identified national and international guidelines. For feasibility, we restricted full appraisal to documents published in English or French. Eligible documents provided explicit recommendations for patients < 18 years. Two reviewers independently extracted data and assessed quality using the AGREE II instrument. Of 144 records screened, 10 guidelines met inclusion criteria; 60% were published within the last 5 years, and 50% were consensus-based without systematic evidence synthesis. Most (90%) endorsed supportive measures such as wound care, nutritional support, and fluid resuscitation. Recommendations for pharmacologic therapy varied considerably: intravenous immunoglobulin (50%), systemic corticosteroids (40%), and cyclosporine (40%), with limited pediatric dosing guidance. Only one guideline mentioned biologics. Multidisciplinary care was recommended in 90%, yet long-term follow-up for sequelae appeared in only 50%. AGREE II appraisal showed high clarity of presentation but consistently low applicability; only the British Association of Dermatologists guideline achieved high quality across all domains. Current pediatric SJS/TEN guidelines display heterogeneity in scope and rigor. While supportive care is emphasized, pharmacologic and long-term management guidance remains inconsistent. Standardized, evidence-based, pediatric-specific guidelines are urgently needed. (© 2026 The Author(s). Pediatric Dermatology published by Wiley Periodicals LLC.) |
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| Contributed Indexing: | Keywords: SJS/TEN; clinical practice guideline; consensus statement; management; pediatrics; systematic review |
| Entry Date(s): | Date Created: 20260216 Date Completed: 20260708 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13206584 |
| DOI: | 10.1111/pde.70149 |
| PMID: | 41698348 |
| Βάση Δεδομένων: | MEDLINE |
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