To predict the mortality risk in patients with Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN).
To guide triage decisions (e.g., admitting to an ICU or specialized Burn Unit).
CLINICAL INSIGHT
How it Works
Risk Factors (1 point each)
Age > 40 years
Heart rate > 120 beats/minute
Presence of malignancy (cancer)
Body surface area (BSA) detached or compromised > 10% on Day 1
Blood Urea Nitrogen (BUN) > 28 mg/dL (>10 mmol/L)
Serum Glucose > 252 mg/dL (>14 mmol/L)
Serum Bicarbonate < 20 mEq/L
Interpretation (Mortality Rate)
Score 0-1: ~3.2%
Score 2: ~12.1%
Score 3: ~35.3%
Score 4: ~58.3%
Score ≥ 5: >90%
CLINICAL INSIGHT
Practical Pearls
Clinical Pearls
Must be calculated within the first 24 hours of admission, and ideally repeated on Day 3 for the most accurate prognostic trajectory.
Heavily weights end-organ stress (tachycardia, uremia, acidosis, hyperglycemia) rather than purely dermatologic signs.
CLINICAL INSIGHT
Next Steps
Critical Actions
Scores ≥ 2 warrant immediate transfer to a specialized Burn Center or Medical ICU, early ophthalmologic consultation, and cessation of all suspected offending drugs.
CLINICAL INSIGHT
Evidence Base
Primary Reference
SCORTEN
SCORTEN: Cross-linked SCORTEN severity scoring for severe cutaneous drug reactions relevant to infectious differentials.
SCORTEN: Predictive mortality risk score for Toxic Epidermal Necrolysis (TEN) and SJS. Must be calculated within 24 hours of admission.