{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:21:58Z","timestamp":1789543318366,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T00:00:00Z","timestamp":1590710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Prior to the first international consensus classification published in 1993, the clinical distinction between erythema multiforme (EM), Stevens\u2010Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) had been subject to uncertainty and controversy for more than a century. Based on this classification, the three conditions are defined by the morphology of the individual lesions and their pattern of distribution. Etiopathogenetically, the majority of EM cases is caused by infections (primarily herpes simplex virus and<jats:italic>Mycoplasma pneumoniae<\/jats:italic>), whereas SJS\/TEN are predominantly triggered by drugs. The SCORTEN (score of toxic epidermal necrolysis) can and should be used to assess disease prognosis in patients with SJS\/TEN.<\/jats:p><jats:p>While supportive treatment is generally considered sufficient for EM, there is still uncertainty as to the type of systemic therapy required for SJS\/TEN. Given the lack of high\u2010quality therapeutic trials and (in some cases) conflicting results, it is currently impossible to issue definitive recommendations for any given immunomodulatory therapy. While there is always a trade\u2010off between rapid onset of treatment\u2010induced immunosuppression and an uptick in infection risk, there has been increasing evidence that cyclosporine in particular may be able to halt disease progression (i.e. skin detachment) and lower mortality rates.<\/jats:p><jats:p>Assistance in diagnosis and management of the aforementioned conditions may be obtained from the Center for the Documentation of Severe Skin Reactions (dZh) at the Department of Dermatology, University Medical Center, Freiburg, Germany.<\/jats:p>","DOI":"10.1111\/ddg.14118","type":"journal-article","created":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T15:33:56Z","timestamp":1590766436000},"page":"547-553","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Erythema multiforme, Stevens\u2010Johnson syndrome\/toxic epidermal necrolysis \u2013 diagnosis and treatment"],"prefix":"10.1111","volume":"18","author":[{"given":"Pavel","family":"Gr\u00fcnwald","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology University Medical Center Rostock Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Mockenhaupt","sequence":"additional","affiliation":[{"name":"Center for the Documentation of Severe Skin Reactions (dZh) Department of Dermatology and Venereology University Medical Center Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Panzer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology University Medical Center Rostock Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Emmert","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology University Medical Center Rostock Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,29]]},"reference":[{"key":"e_1_2_6_2_1","article-title":"Acute Exantheme und Hautkrankheiten, Verlag von Ferdinand von Enke","author":"Hebra F","year":"1860","journal-title":"Erlangen"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.4667.1393"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1956.tb12766.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1993.01680220104023"},{"key":"e_1_2_6_6_1","volume-title":"Fitzpatrick\u2019s dermatology","author":"Mockenhaupt M","year":"2019"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13352"},{"key":"e_1_2_6_8_1","first-page":"6","article-title":"Histopathological and epidemiological characteristics of patients with erythema exudativum multiforme majus, Stevens\u2010Johnson syndrome and toxic epidermal necrolysis","volume":"135","author":"Rzany B","year":"1996","journal-title":"Br J Dermatol"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.5772\/22335"},{"key":"e_1_2_6_10_1","first-page":"332","volume-title":"Dermatology","author":"H\u00f6tzenecker W","year":"2018"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12133"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jid.5701033"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.11.023"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S163391"},{"key":"e_1_2_6_15_1","unstructured":"AWMF\u2010S3\u2010Leitlinie. 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