skip to main content

Stevens-Johnson syndrome/toxic epidermal necrolysis — ABIM Board MCQ

Instant feedback + full explanation. One question, done properly.

HardDermatologyStevens-Johnson syndrome/toxic epidermal necrolysisABIM Board

A 39-year-old man develops fever, oral and ocular erosions, tender dusky macules, and epidermal sloughing three weeks after starting lamotrigine. Detached or readily detachable epidermis involves 12% of body surface area. Which classification is most accurate?

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

Reveal the answer and explanation

Correct answer: B — Classify this as SJS-TEN overlap with 12% epidermal detachment

The best answer is “Classify this as SJS-TEN overlap with 12% epidermal detachment”. The SJS/TEN spectrum is classified by detached or detachable skin: less than 10% is SJS, 10% to 30% is overlap, and more than 30% is TEN. Mucosal involvement supports the syndrome but does not determine its severity category. Lamotrigine is a recognized trigger. The drug must be stopped immediately and the patient transferred for expert supportive, ophthalmologic, and mucosal care.

Reference: Update on Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: https://pmc.ncbi.nlm.nih.gov/articles/PMC11511757/