Stevens-Johnson syndrome or toxic epidermal necrolysis should be managed with:

• A. Supportive care and wound management + ICU burn unit admission
• B. Systemic steroids
• C. Antibiotics only
• D. Observation at home

Answer: (A)

The main concept is that extensive skin loss from Stevens-Johnson syndrome or toxic epidermal necrolysis behaves like a burn injury, so the best management is aggressive supportive care in a setting equipped to handle burn patients. This means admission to an ICU or burn unit where fluid and electrolyte balance can be tightly monitored, temperature and nutrition maintained, and wound care and infection prevention can be specialized. Wound management with sterile dressings and careful handling reduces pain and infection risk, while multidisciplinary support addresses respiratory, renal, and other potential organ concerns as the condition evolves.

Systemic steroids are not routinely used as the primary treatment because they have not consistently shown clear benefit and can raise the risk of infection and delay healing. Antibiotics alone don’t treat the underlying mucocutaneous disease; they’re only relevant if an infection actually develops. Observing at home is inappropriate due to the high risk of rapid progression, dehydration, sepsis, and multi-organ failure.