Stevens-Johnson syndrome and toxic epidermal necrolysis typically require admission to which unit?

• A. General medical floor
• B. ICU burn unit
• C. Cardiac ICU
• D. Pediatric ward

Answer: (B)

This question tests understanding that extensive skin loss from Stevens-Johnson syndrome or toxic epidermal necrolysis behaves like a burn injury in terms of fluid shifts, infection risk, and wound care needs. When a large body surface area is detaching, the skin barrier is severely compromised, leading to massive insensible fluid losses, electrolyte imbalances, heat loss, and a high risk of sepsis. Proper management requires specialized, multidisciplinary burn-care expertise: meticulous wound care with sterile techniques, appropriate dressings or wound coverings, precise fluid management, infection control measures, temperature regulation, and aggressive nutritional and analgesic support. An ICU burn unit is equipped to handle these complex needs and provides the protocols and staffing necessary for patients with extensive epidermal detachment, regardless of age. In contrast, a general medical floor lacks the specialized wound-care resources and monitoring intensity, a cardiac ICU focuses on cardiovascular issues rather than the dermatologic and infectious complications, and a pediatric ward may not have the same level of experience with adults who have large-area burns or burn-like skin loss.