Lamotrigine-associated SJS/TEN overlap — SCE Acute Medicine MCQ

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HardAcute Rheumatological/Dermatological EmergenciesLamotrigine-associated SJS/TEN overlapSCE Acute Medicine

A 36-year-old woman has epidermal detachment over 18% body-surface area after lamotrigine. At admission her heart rate is 118/min, urea 12 mmol/L, bicarbonate 19 mmol/L and glucose 16 mmol/L; she has no malignancy. What is her SCORTEN?

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Correct answer: B — 4

Explanation lettering: D = shown as A · A = shown as D

B is correct. SCORTEN assigns one point each for age over 40, malignancy, heart rate over 120/min, epidermal detachment over 10%, urea over 10 mmol/L, glucose over 14 mmol/L and bicarbonate below 20 mmol/L. She scores for detachment, urea, glucose and bicarbonate: 4. Age, malignancy and heart-rate criteria are absent. The culprit drug must be stopped and she needs multidisciplinary care in a unit experienced in extensive skin loss; the score estimates mortality but does not replace clinical escalation.

Reference: https://onlinelibrary.wiley.com/doi/10.1111/bjd.14530