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Stevens-Johnson syndrome — SCE Acute Medicine MCQ

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ModerateAcute Rheumatological and Dermatological EmergenciesStevens-Johnson syndromeSCE Acute Medicine

A 63-year-old woman presents with rash, allergic features, visual symptoms or systemic inflammation. Relevant history includes recent drug exposure, autoimmune disease or allergen exposure. On assessment, skin, mucosal or vascular findings suggest systemic disease. Investigations show mucosal erosions, skin pain and detachment after lamotrigine. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Stevens-Johnson syndrome

The key discriminator is that mucosal erosions, skin pain and detachment after lamotrigine, which makes Stevens-Johnson syndrome the single best answer. Pulmonary embolism is less appropriate because it does not address the dominant acute risk in the vignette; Aortic dissection would fit a different presentation or later stage of care. Bacterial meningitis and Diabetic ketoacidosis are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: BAD SJS/TEN guideline; BNF