A generalized scalded type of skin reaction, often due to allergic reaction to drugs. A similar reaction occurs in children termed staphylococcal scalded skin syndrome which is caused by Staphylococcus aureus.
TREATMENT
Therapeutic objectives
• To maintain adequate hydration
• To prevent secondary infection
• To identify and eliminate underlying condition
Pharmacological Treatment
(Evidence rating: C)
Erythema multiforme, Steven Johnson Syndrome and TEN should be considered as emergencies requiring intensive care.
• Rehydration by IV, nasogastric or oral routes
• Withdrawal of identifiable causative factors
• Do not give antibiotics unless there is frank pus or microbiological evidence of infection
• Where there is frank pus and microbiological evidence is unavailable, Erythromycin and Metronidazole could be used
• Systemic steroids have been used but conclusive evidence of their efficacy is lacking
• Relieve pain with Paracetamol, oral, 6 hourly
| |
Adults: |
500 mg - 1 g |
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Children |
|
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3 months-1 year; |
60-120 mg |
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1-5 years; |
120-250 mg |
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6-12 years; |
250-500 mg |
or
if severe, Pethidine, IM,
| |
Adults: |
25-100 mg 4 hourly as required |
| |
Children: |
0.5-2 mg/kg body weight repeated every 4 hours as required |
• Apply Gentian violet, Mercurochrome or topical antiseptic e.g. cetrimide to skin only.
Strict input/output chart maintenance to ensure adequate urine output.
REFER
Refer to appropriate centres if local facilities are inadequate.
Refer to eye specialist if eyes are involved
