{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:57:16Z","timestamp":1790571436309,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"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>Background<\/jats:title>\n                    <jats:p>Paediatric Stevens\u2013Johnson syndrome\/toxic epidermal necrolysis (SJS\/TEN) is a rare, severe mucocutaneous reaction requiring coordinated multidisciplinary care. Existing guidelines provide evidence\u2010based recommendations, but implementation across tertiary paediatric hospitals requires practical consensus on local resources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To develop and evaluate multidisciplinary consensus\u2010informed practical clinical guidance for assessment and management of paediatric SJS\/TEN among clinicians from Australasian tertiary referral hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A draft guidance document was developed after review of SJS\/TEN guidelines, systematic reviews and other relevant literature. Clinicians from one tertiary paediatric centre (Group A) and other Australian and New Zealand tertiary centres (Group B) completed a 130\u2010item questionnaire. Continuous items were scored on a 1\u20139 Likert scale. Categorical items addressed referral urgency and whether investigations should be routine, reasonable but not routine, or not ordered. Quantitative responses and free\u2010text comments informed revision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010two multidisciplinary clinicians from the internal centre and nine clinicians from eight external centres participated. Agreement was high for history, examination, supportive care, multidisciplinary involvement, discharge planning and follow\u2010up. Uncertainty remained regarding fluid requirements compared with burns patients, the scope of initial investigations and systemic immunomodulatory therapy. The guidance was revised to emphasise individualised fluid management, directed differential diagnosis and testing, and case\u2010by\u2010case systemic therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This practical multidisciplinary consensus\u2010informed guidance supports paediatric SJS\/TEN care in Australasian tertiary referral hospitals. Its contribution is the quantified consultative process and identification of consistent, variable and uncertain practice. It complements, rather than replaces, existing guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70435","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T06:14:14Z","timestamp":1780294454000},"page":"1578-1584","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of Multidisciplinary Consensus\u2010Informed Guidance for the Management of Paediatric Stevens\u2013Johnson Syndrome and Toxic Epidermal Necrolysis Among Clinicians From Australasian Tertiary Referral Hospitals"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9976-2691","authenticated-orcid":false,"given":"Patrick David","family":"Mahar","sequence":"first","affiliation":[{"name":"Skin Health Institute  Melbourne Victoria Australia"},{"name":"Department of Dermatology The Royal Children\u2019s Hospital  Melbourne Victoria Australia"},{"name":"Burns Unit, Trauma Service The Royal Children\u2019s Hospital  Melbourne Victoria Australia"},{"name":"Faculty of Medicine, Dentistry &amp; Health Sciences The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Lee","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dentistry &amp; Health Sciences The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6656-6283","authenticated-orcid":false,"given":"David","family":"Orchard","sequence":"additional","affiliation":[{"name":"Department of Dermatology The Royal Children\u2019s Hospital  Melbourne Victoria Australia"},{"name":"Faculty of Medicine, Dentistry &amp; Health Sciences The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0127-0769","authenticated-orcid":false,"given":"Amy","family":"Gray","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dentistry &amp; Health Sciences The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of General Medicine The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6160-8886","authenticated-orcid":false,"given":"Laura","family":"Scardamaglia","sequence":"additional","affiliation":[{"name":"Department of Dermatology The Royal Children\u2019s Hospital  Melbourne Victoria Australia"},{"name":"Faculty of Medicine, Dentistry &amp; Health Sciences The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Dermatology The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Dermatology Western Health  Footscray Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4790-9943","authenticated-orcid":false,"given":"Susan","family":"Robertson","sequence":"additional","affiliation":[{"name":"Department of Dermatology The Royal Children\u2019s Hospital  Melbourne Victoria Australia"},{"name":"Faculty of Medicine, Dentistry &amp; Health Sciences The University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Dermatology The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Murdoch Children\u2019s Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3883-1243","authenticated-orcid":false,"given":"Monique","family":"Bertinetti","sequence":"additional","affiliation":[{"name":"Burns Unit, Trauma Service The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4747-6025","authenticated-orcid":false,"given":"Warwick","family":"Teague","sequence":"additional","affiliation":[{"name":"Burns Unit, Trauma Service The Royal Children\u2019s Hospital  Melbourne Victoria Australia"},{"name":"Faculty of Medicine, Dentistry &amp; Health Sciences The University of Melbourne  Melbourne Victoria Australia"},{"name":"Murdoch Children\u2019s Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0175-0124","authenticated-orcid":false,"given":"Danielle","family":"Nizzero","sequence":"additional","affiliation":[{"name":"Burns Unit, Trauma Service The Royal Children\u2019s Hospital  Melbourne Victoria Australia"},{"name":"Department of Plastic &amp; Reconstructive Surgery Monash Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Grills","sequence":"additional","affiliation":[{"name":"Department of Dermatology The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Toholka","sequence":"additional","affiliation":[{"name":"Department of Dermatology The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danni","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of General Medicine The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of General Medicine The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3047-4552","authenticated-orcid":false,"given":"Joanne","family":"Grindlay","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dentistry &amp; Health Sciences The University of Melbourne  Melbourne Victoria Australia"},{"name":"Murdoch Children\u2019s Research Institute  Melbourne Victoria Australia"},{"name":"Emergency Department The Royal Children\u2019s Hospital  Melbourne Victoria Australia"},{"name":"Department of Critical Care The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Rozen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dentistry &amp; Health Sciences The University of Melbourne  Melbourne Victoria Australia"},{"name":"Murdoch Children\u2019s Research Institute  Melbourne Victoria Australia"},{"name":"Department of Critical Care The Royal Children\u2019s Hospital  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventative Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Oliver","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dentistry &amp; Health Sciences The University of Melbourne  Melbourne Victoria Australia"},{"name":"Murdoch Children\u2019s Research Institute  Melbourne Victoria Australia"},{"name":"Department of Gastroenterology &amp; Clinical Nutrition The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Alexander","sequence":"additional","affiliation":[{"name":"Burns Unit, Trauma Service The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashan","family":"Fernando","sequence":"additional","affiliation":[{"name":"Burns Unit, Trauma Service The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu","family":"Matthew","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology The Royal Children\u2019s Hospital  Melbourne Victoria Australia"},{"name":"Department of Ophthalmology The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7037-0272","authenticated-orcid":false,"given":"Kiri","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Gynaecology The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5183-2892","authenticated-orcid":false,"given":"Sonia R.","family":"Grover","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Dentistry &amp; 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Health Sciences The University of Melbourne  Melbourne Victoria Australia"},{"name":"The Education Hub The Royal Children\u2019s Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,31]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890701753664"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2017.01.031"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.17841"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14530"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2025.101046"},{"key":"e_1_2_12_7_1","unstructured":"National Health and Medical Research Council \u201cNHMRC Additional Levels of Evidence and Grades for Recommendations for Developers of Guidelines. Commonwealth of Australia \u201d(2009)."},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0000000000000830"},{"issue":"3","key":"e_1_2_12_9_1","article-title":"Pemphigus Vulgaris Mimicking Stevens\u2010Johnson Syndrome and Toxic Epidermal Necrolysis: Report of an Unusual Case","volume":"15","author":"Albrahim L.","year":"2023","journal-title":"Dermatology Reports"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.4081\/dr.2010.e6"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/BCR.0b013e3181cb8cb8"},{"issue":"3","key":"e_1_2_12_12_1","article-title":"Systemic Interventions for Treatment of Stevens\u2010Johnson Syndrome, Toxic Epidermal Necrolysis, and SJS\/TEN Overlap Syndrome","volume":"3","author":"Jacobsen A.","year":"2022","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alit.2025.05.008"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-024-08061-0"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-024-02122-6"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.70034"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anpede.2023.08.003"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2011.07.015"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2024.10.004"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70435","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.70435","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70435","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:52:31Z","timestamp":1790571151000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.70435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,31]]},"references-count":18,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/jpc.70435"],"URL":"https:\/\/doi.org\/10.1111\/jpc.70435","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,31]]},"assertion":[{"value":"2025-11-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}