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However, minimal evaluation of photo-induced SJS\/TEN has been conducted. Thus, this review identifies all cases of SJS\/TEN that are linked to an acute exposure of UVR and outlines the unifying characteristics of these cases. Furthermore, the theoretical pathogenesis, differential diagnoses, and proposed diagnostic criteria are defined.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>PubMed, Google Scholar, and other databases and websites were searched from inception to September 2021 to identify studies that met inclusion criteria. The following keywords were utilized: \u201cStevens-Johnson syndrome\u201d and \u201ctoxic epidermal necrolysis\u201d with \u201cultraviolet,\u201d \u201cphotodistributed,\u201d \u201cphoto-induced,\u201d \u201cphotosensitivity,\u201d and \u201cphoto.\u201d One reviewer assessed study characteristics, with confirmation by a second. The risk of bias was assessed independently by another.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Thirteen patient cases were identified, all reporting ultraviolet radiation prior to rash onset and an underlying causal drug. Case classifications included 7\/13 SJS and 6\/13 TEN. All cases described the rash as photodistributed with UVR exposure prior to rash onset (delay of 1\u20133\u00a0days) and a causal drug. 10 cases provided evidence that the photodistributed rash lacked linear demarcation (as in a sunburn) with satellite target-like lesions. No cases described a flu-like prodrome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>Mucositis, palmar and plantar rash, a positive Nikolsky sign, and a prolonged disease course can help distinguish from photosensitive reactions, while a negative direct immunofluorescence test is important to distinguish from other photo-induced disorders.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Physicians should be aware that UVR may precipitate SJS\/TEN in patients taking susceptible drugs. After a 24-h delay from UVR exposure, a non-distinct, photodistributed rash appears with no flu-like prodrome and progresses for at least 48\u00a0h to include vesiculobullous eruptions and mucous membrane involvement. Photodistributed SJS\/TEN appears to be photo-drug-induced with a unique onset and rash presentation that should be recognized as a distinct diagnosis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40001-023-01142-2","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T03:10:54Z","timestamp":1686539454000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Photodistributed Stevens\u2013Johnson syndrome and toxic epidermal necrolysis: a systematic review and proposal for a new diagnostic classification"],"prefix":"10.1186","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7513-1481","authenticated-orcid":false,"given":"Blake Jeffrey","family":"McKinley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell Edger","family":"Allen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Michels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,12]]},"reference":[{"key":"1142_CR1","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1007\/s12016-017-8654-z","volume":"54","author":"M Lerch","year":"2018","unstructured":"Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T. 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