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Her rash continued to worsen and she was transferred to our medical intensive care unit (ICU), where broad-spectrum antibiotics were discontinued and she was treated with supportive care as well as \u2018low-dose\u2019 intravenous hydrocortisone, ascorbic acid (vitamin C) and thiamine (HAT therapy). After starting this therapy, the patient demonstrated a dramatic response with rapid improvement of her cutaneous and mucosal lesions. She was tolerating a diet provided by the hospital on day 4 and was discharged from the ICU a few days later.<\/jats:p>","DOI":"10.1136\/bcr-2019-230538","type":"journal-article","created":{"date-parts":[[2019,11,2]],"date-time":"2019-11-02T10:06:10Z","timestamp":1572689170000},"page":"e230538","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Stevens-Johnson syndrome\/toxic epidermal necrolysis: treatment with low-dose corticosteroids, vitamin C and thiamine"],"prefix":"10.1136","volume":"12","author":[{"given":"Matthew Middendorf","family":"Middendorf","sequence":"first","affiliation":[{"name":"Internal Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad Z","family":"Busaileh","sequence":"additional","affiliation":[{"name":"Internal Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arneh","family":"Babakhani","sequence":"additional","affiliation":[{"name":"Internal Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul Ellis","family":"Marik","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,11,2]]},"reference":[{"key":"2025082711202705000_12.11.e230538.1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1993.01680250078010"},{"key":"2025082711202705000_12.11.e230538.2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1996.d01-924.x"},{"key":"2025082711202705000_12.11.e230538.3","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1016\/j.jid.2016.03.023","article-title":"Morbidity and mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis in United States adults","volume":"136","author":"Hsu","year":"2016","journal-title":"J Invest Dermatol"},{"key":"2025082711202705000_12.11.e230538.4","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.anai.2016.11.019","article-title":"Stevens-Johnson syndrome and toxic epidermal necrolysis","volume":"118","author":"Eginli","year":"2017","journal-title":"Ann Allergy Asthma Immunol"},{"key":"2025082711202705000_12.11.e230538.5","doi-asserted-by":"crossref","first-page":"e119","DOI":"10.1016\/j.bjps.2016.01.034","article-title":"Uk guidelines for the management of Stevens-Johnson syndrome\/toxic epidermal necrolysis in adults 2016","volume":"69","author":"Creamer","year":"2016","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2025082711202705000_12.11.e230538.6","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1001\/jamadermatol.2016.5668","article-title":"Systemic immunomodulating therapies for Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis","volume":"153","author":"Zimmermann","year":"2017","journal-title":"JAMA Dermatol"},{"key":"2025082711202705000_12.11.e230538.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2008.12.040"},{"key":"2025082711202705000_12.11.e230538.8","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1007\/s12325-017-0530-y","article-title":"Stevens-Johnson syndrome and toxic epidermal necrolysis: a concise review with a comprehensive summary of therapeutic interventions emphasizing supportive measures","volume":"34","author":"Schneider","year":"2017","journal-title":"Adv Ther"},{"key":"2025082711202705000_12.11.e230538.9","doi-asserted-by":"crossref","first-page":"194","DOI":"10.3390\/toxins6010194","article-title":"Cytotoxic proteins and therapeutic targets in severe cutaneous adverse reactions","volume":"6","author":"Su","year":"2014","journal-title":"Toxins"},{"key":"2025082711202705000_12.11.e230538.10","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/j.chest.2016.11.036","article-title":"Hydrocortisone, vitamin C and thiamine for the treatment of severe sepsis and septic shock: a retrospective before-after study","volume":"151","author":"Marik","year":"2017","journal-title":"Chest"},{"key":"2025082711202705000_12.11.e230538.11","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1016\/j.chest.2017.07.014","article-title":"Hydrocortisone and ascorbic acid synergistically prevent and repair lipopolysaccharide-induced pulmonary endothelial barrier dysfunction","volume":"152","author":"Barabutis","year":"2017","journal-title":"Chest"},{"key":"2025082711202705000_12.11.e230538.12","doi-asserted-by":"crossref","unstructured":"Moskowitz A , Andersen LW , Huang DT , et al . 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