{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:57:15Z","timestamp":1790571435363,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The role of systemic therapy in paediatric Stevens\u2013Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) remains undefined. Management is primarily guided by observational data and variable practice patterns. This systematic review aims to integrate recent evidence and evaluate clinical outcomes associated with systemic therapies in paediatric SJS\/TEN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Embase and Scopus was conducted from January 1990 to February 2025. Studies were eligible if they included patients (&lt;\u200918\u2009years) with SJS, SJS\u2010TEN overlap or TEN managed with supportive care alone or systemic therapy (corticosteroids, intravenous immunoglobulin (IVIg), cyclosporin, TNF\u2010\u03b1 inhibitors or plasmapheresis). Studies without defined diagnoses or outcomes were excluded. Primary outcomes were mortality and length of hospital stay. Risk of bias was assessed using CARE guidelines for case reports and the Joanna\u2010Briggs checklist for observational studies. Studies providing individual\u2010level data were synthesised quantitatively, while aggregated data were described narratively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 260 studies comprising 1608 paediatric patients met inclusion criteria. Most patients received systemic therapy, most commonly corticosteroids or IVIg. Systemic therapy was not associated with a shorter length of stay or reduced mortality rate compared to supportive care alone. Treatment with cyclosporin and TNF\u2010\u03b1 inhibitors trended towards lower mortality rates, and for cyclosporin, shorter length of stay. However, these findings did not reach statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Evidence for systemic therapy remains limited by study heterogeneity and small sample sizes. Although emerging targeted therapies show early promise, firm conclusions regarding efficacy cannot be drawn. This highlights the need for further collaborative research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70432","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T05:58:18Z","timestamp":1779083898000},"page":"1570-1577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Therapy for Paediatric Stevens\u2013Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review of Current Evidence and Limitations"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0412-4230","authenticated-orcid":false,"given":"Samantha","family":"Ting","sequence":"first","affiliation":[{"name":"Royal Prince Alfred Hospital  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4095-4605","authenticated-orcid":false,"given":"Kangjie Reuel","family":"Chua","sequence":"additional","affiliation":[{"name":"Royal Prince Alfred Hospital  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Chuen","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Dermatology The Children's Hospital at Westmead  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Fong","sequence":"additional","affiliation":[{"name":"Royal Prince Alfred Hospital  Sydney Australia"},{"name":"Department of Dermatology The Children's Hospital at Westmead  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2017.11.023"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1993.01680220104023"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BCR.0000000000000208"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2023.08.009"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2016.12.024"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.15047"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.17841"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.20419.1"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000001146"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40272-022-00515-0"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.70149"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.136.3.323"},{"key":"e_1_2_9_14_1","article-title":"Systemic Interventions for Treatment of Stevens\u2010Johnson Syndrome (SJS), toxic Epidermal Necrolysis (TEN), and SJS\/TEN Overlap Syndrome","volume":"3","author":"Jacobsen A.","year":"2022","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI93349"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2017.05.022"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-023-00928-w"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S540221"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-024-08061-0"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.70034"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2025.11.011"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/derm.2024.0229"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2024.107779"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.04.026"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.11124\/JBISRIR-D-19-00099"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2018.05.024"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/3061084"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-3322"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.1.74"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2017.09.015"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/8163588"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5154.96192"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.16476"},{"key":"e_1_2_9_34_1","article-title":"A Systematic Review of Treatment of Drug\u2010Induced Stevens\u2010Johnson Syndrome and Toxic Epidermal Necrolysis in Children","volume":"18","author":"Del Pozzo\u2010Magana B. 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