From the Guidelines
Stevens-Johnson Syndrome (SJS) diagnostic tests include a combination of clinical assessment, laboratory investigations, and histopathological examination. The diagnosis of SJS is primarily based on clinical features, including a prodromal illness, onset of a painful rash, and involvement of mucosal sites [ 1 ].
Diagnostic Tests
- Clinical assessment: A detailed history and physical examination, including assessment of mucosae and skin biopsy if any diagnostic uncertainty [ 1 ].
- Laboratory investigations: Full blood count, erythrocyte sedimentation rate, C-reactive protein, urea and electrolytes, magnesium, phosphate, bicarbonate, glucose, liver function tests, coagulation studies, and mycoplasma serology [ 1 ].
- Histopathological examination: Skin biopsy or frozen section of a blister roof to identify the plane of cleavage and exclude other blistering dermatoses [ 1 ].
- Imaging studies: Chest X-ray to evaluate for respiratory involvement [ 1 ].
- Microbiological studies: Swabs from lesional skin for bacteriology to identify potential infectious causes [ 1 ].
Key Considerations
- Differential diagnosis: Staphylococcal scalded skin syndrome (SSSS) and other blistering dermatoses should be excluded based on clinical and histopathological features [ 1 ].
- Infectious causes: Infections such as herpes simplex virus (HSV) and Mycoplasma pneumoniae should be considered as potential triggers for SJS/TEN [ 1 ].
From the Research
Diagnostic Tests for Stevens-Johnson Syndrome (SJS)
The diagnosis of Stevens-Johnson Syndrome (SJS) involves various tests to confirm the condition and identify the underlying cause. Some of the diagnostic tests for SJS include:
- Immunochromatographic test for serum granulysin, which is useful for predicting the progression of SJS/TEN 2
- In vivo tests, such as patch tests (PTs) and delayed-reading intradermal tests (IDTs), which can be performed to identify the causative drug 3
- In vitro tests, including lymphocyte transformation test (LTT) and cyto-LTT, which have shown promising results in diagnosing SJS/TEN 3
- Biomarkers, such as galectin 7 and RIP3, which are being researched as potential diagnostic markers for SJS/TEN 4
Laboratory Tests
Laboratory tests, such as enzyme-linked immunosorbent assays (ELISA), can be used to detect elevated serum granulysin levels, which are associated with SJS/TEN 2. Additionally, tests to identify the underlying cause of SJS, such as drug-T cell activation tests, can be performed 5.
Clinical Assessment
Clinical assessment tools, such as those used to evaluate the severity of SJS/TEN, can aid in the diagnosis and management of the condition 4, 5. A comprehensive diagnosis and management plan should be guided by the latest research and clinical guidelines, as outlined in recent reviews on the topic 6, 4.