Supportive care in the acute phase of Stevens–Johnson syndrome and toxic epidermal necrolysis: an international, multidisciplinary Delphi-based consensus

M. C. Brüggen; S. T. Le; S. Walsh; A. Toussi; N. de Prost; A. Ranki; B. Didona; A. Colin; B. Horváth; E. Brezinova; B. Milpied; C. Moss; C. Bodemer; D. Meyersburg; C. Salavastru; G. S. Tiplica; E. Howard; E. Bequignon; J. N. Bouwes Bavinck; J. Newman; J. Gueudry; M. Nägeli; K. Zaghbib; K. Pallesen; A. Bygum; P. Joly; P. Wolkenstein; S. L. Chua; R. Le Floch; N. H. Shear; C. Y. Chu; N. Hama; R. Abe; W. H. Chung; T. Shiohara; M. Ardern-Jones; P. Romanelli; E. J. Phillips; R. S. Stern; J. Cotliar; R. G. Micheletti; A. Brassard; J. T. Schulz; R. P. Dodiuk-Gad; A. R. Dominguez; A. S. Paller; L. Seminario-Vidal; A. Mostaghimi; M. H. Noe; S. Worswick; D. Tartar; R. Sheridan; B. H. Kaffenberger; K. Shinkai; E. Maverakis; L. E. French; S. Ingen-Housz-Oro

doi:10.1111/bjd.19893

Supportive care in the acute phase of Stevens–Johnson syndrome and toxic epidermal necrolysis: an international, multidisciplinary Delphi-based consensus

M. C. Brüggen, S. T. Le, S. Walsh, A. Toussi, N. de Prost, A. Ranki, B. Didona, A. Colin, B. Horváth, E. Brezinova, B. Milpied, C. Moss, C. Bodemer, D. Meyersburg, C. Salavastru, G. S. Tiplica, E. Howard, E. Bequignon, J. N. Bouwes Bavinck, J. NewmanJ. Gueudry, M. Nägeli, K. Zaghbib, K. Pallesen, A. Bygum, P. Joly, P. Wolkenstein, S. L. Chua, R. Le Floch, N. H. Shear, C. Y. Chu, N. Hama, R. Abe, W. H. Chung, T. Shiohara, M. Ardern-Jones, P. Romanelli, E. J. Phillips, R. S. Stern, J. Cotliar, R. G. Micheletti, A. Brassard, J. T. Schulz, R. P. Dodiuk-Gad, A. R. Dominguez, A. S. Paller, L. Seminario-Vidal, A. Mostaghimi, M. H. Noe, S. Worswick, D. Tartar, R. Sheridan, B. H. Kaffenberger, K. Shinkai, E. Maverakis, L. E. French, S. Ingen-Housz-Oro

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

Background: Supportive care is the cornerstone of management of adult and paediatric Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, consensus on the modalities of supportive care is lacking. Objectives: Our aim in this international multicentric Delphi exercise was to establish a multidisciplinary expert consensus to standardize recommendations regarding supportive care in the acute phase of SJS/TEN. Methods: Participants were sent a survey via the online tool SurveyMonkey, consisting of 103 statements organized into 11 topics: multidisciplinary team composition, suspect drug management, infection prevention, fluid resuscitation and prevention of hypothermia, nutritional support, pain and psychological distress management, management of acute respiratory failure, local skincare, ophthalmological management, management of other mucosa, and additional measures. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). The results were analysed according to the RAND/UCLA Appropriateness Method. Results: Forty-five participants from 13 countries (on three continents) participated. After the first round, a consensus was obtained for 82.5% of the 103 initially proposed statements. After the second round, a final consensus was obtained for 102 statements. Conclusions: We have reached an international Delphi-based consensus on best supportive care practice for SJS/TEN. Our expert consensus should help guide physicians in treating patients with SJS/TEN and thereby improve short-term prognosis and the risk of sequelae.

Original language	English (US)
Pages (from-to)	616-626
Number of pages	11
Journal	British Journal of Dermatology
Volume	185
Issue number	3
DOIs	https://doi.org/10.1111/bjd.19893
State	Published - Sep 2021

ASJC Scopus subject areas

Dermatology

Access to Document

10.1111/bjd.19893

Cite this

Brüggen, M. C., Le, S. T., Walsh, S., Toussi, A., de Prost, N., Ranki, A., Didona, B., Colin, A., Horváth, B., Brezinova, E., Milpied, B., Moss, C., Bodemer, C., Meyersburg, D., Salavastru, C., Tiplica, G. S., Howard, E., Bequignon, E., Bouwes Bavinck, J. N., ... Ingen-Housz-Oro, S. (2021). Supportive care in the acute phase of Stevens–Johnson syndrome and toxic epidermal necrolysis: an international, multidisciplinary Delphi-based consensus. British Journal of Dermatology, 185(3), 616-626. https://doi.org/10.1111/bjd.19893

Brüggen, MC, Le, ST, Walsh, S, Toussi, A, de Prost, N, Ranki, A, Didona, B, Colin, A, Horváth, B, Brezinova, E, Milpied, B, Moss, C, Bodemer, C, Meyersburg, D, Salavastru, C, Tiplica, GS, Howard, E, Bequignon, E, Bouwes Bavinck, JN, Newman, J, Gueudry, J, Nägeli, M, Zaghbib, K, Pallesen, K, Bygum, A, Joly, P, Wolkenstein, P, Chua, SL, Le Floch, R, Shear, NH, Chu, CY, Hama, N, Abe, R, Chung, WH, Shiohara, T, Ardern-Jones, M, Romanelli, P, Phillips, EJ, Stern, RS, Cotliar, J, Micheletti, RG, Brassard, A, Schulz, JT, Dodiuk-Gad, RP, Dominguez, AR, Paller, AS, Seminario-Vidal, L, Mostaghimi, A, Noe, MH, Worswick, S, Tartar, D, Sheridan, R, Kaffenberger, BH, Shinkai, K, Maverakis, E, French, LE & Ingen-Housz-Oro, S 2021, 'Supportive care in the acute phase of Stevens–Johnson syndrome and toxic epidermal necrolysis: an international, multidisciplinary Delphi-based consensus', British Journal of Dermatology, vol. 185, no. 3, pp. 616-626. https://doi.org/10.1111/bjd.19893

@article{ae02038d11e041e2a8b2863fed92cf5d,

title = "Supportive care in the acute phase of Stevens–Johnson syndrome and toxic epidermal necrolysis: an international, multidisciplinary Delphi-based consensus",

abstract = "Background: Supportive care is the cornerstone of management of adult and paediatric Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, consensus on the modalities of supportive care is lacking. Objectives: Our aim in this international multicentric Delphi exercise was to establish a multidisciplinary expert consensus to standardize recommendations regarding supportive care in the acute phase of SJS/TEN. Methods: Participants were sent a survey via the online tool SurveyMonkey, consisting of 103 statements organized into 11 topics: multidisciplinary team composition, suspect drug management, infection prevention, fluid resuscitation and prevention of hypothermia, nutritional support, pain and psychological distress management, management of acute respiratory failure, local skincare, ophthalmological management, management of other mucosa, and additional measures. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). The results were analysed according to the RAND/UCLA Appropriateness Method. Results: Forty-five participants from 13 countries (on three continents) participated. After the first round, a consensus was obtained for 82.5% of the 103 initially proposed statements. After the second round, a final consensus was obtained for 102 statements. Conclusions: We have reached an international Delphi-based consensus on best supportive care practice for SJS/TEN. Our expert consensus should help guide physicians in treating patients with SJS/TEN and thereby improve short-term prognosis and the risk of sequelae.",

author = "Br{\"u}ggen, {M. C.} and Le, {S. T.} and S. Walsh and A. Toussi and {de Prost}, N. and A. Ranki and B. Didona and A. Colin and B. Horv{\'a}th and E. Brezinova and B. Milpied and C. Moss and C. Bodemer and D. Meyersburg and C. Salavastru and Tiplica, {G. S.} and E. Howard and E. Bequignon and {Bouwes Bavinck}, {J. N.} and J. Newman and J. Gueudry and M. N{\"a}geli and K. Zaghbib and K. Pallesen and A. Bygum and P. Joly and P. Wolkenstein and Chua, {S. L.} and {Le Floch}, R. and Shear, {N. H.} and Chu, {C. Y.} and N. Hama and R. Abe and Chung, {W. H.} and T. Shiohara and M. Ardern-Jones and P. Romanelli and Phillips, {E. J.} and Stern, {R. S.} and J. Cotliar and Micheletti, {R. G.} and A. Brassard and Schulz, {J. T.} and Dodiuk-Gad, {R. P.} and Dominguez, {A. R.} and Paller, {A. S.} and L. Seminario-Vidal and A. Mostaghimi and Noe, {M. H.} and S. Worswick and D. Tartar and R. Sheridan and Kaffenberger, {B. H.} and K. Shinkai and E. Maverakis and French, {L. E.} and S. Ingen-Housz-Oro",

note = "Publisher Copyright: {\textcopyright} 2021 British Association of Dermatologists",

year = "2021",

month = sep,

doi = "10.1111/bjd.19893",

language = "English (US)",

volume = "185",

pages = "616--626",

journal = "British Journal of Dermatology",

issn = "0007-0963",

publisher = "Wiley-Blackwell",

number = "3",

}

TY - JOUR

T1 - Supportive care in the acute phase of Stevens–Johnson syndrome and toxic epidermal necrolysis

T2 - an international, multidisciplinary Delphi-based consensus

AU - Brüggen, M. C.

AU - Le, S. T.

AU - Walsh, S.

AU - Toussi, A.

AU - de Prost, N.

AU - Ranki, A.

AU - Didona, B.

AU - Colin, A.

AU - Horváth, B.

AU - Brezinova, E.

AU - Milpied, B.

AU - Moss, C.

AU - Bodemer, C.

AU - Meyersburg, D.

AU - Salavastru, C.

AU - Tiplica, G. S.

AU - Howard, E.

AU - Bequignon, E.

AU - Bouwes Bavinck, J. N.

AU - Newman, J.

AU - Gueudry, J.

AU - Nägeli, M.

AU - Zaghbib, K.

AU - Pallesen, K.

AU - Bygum, A.

AU - Joly, P.

AU - Wolkenstein, P.

AU - Chua, S. L.

AU - Le Floch, R.

AU - Shear, N. H.

AU - Chu, C. Y.

AU - Hama, N.

AU - Abe, R.

AU - Chung, W. H.

AU - Shiohara, T.

AU - Ardern-Jones, M.

AU - Romanelli, P.

AU - Phillips, E. J.

AU - Stern, R. S.

AU - Cotliar, J.

AU - Micheletti, R. G.

AU - Brassard, A.

AU - Schulz, J. T.

AU - Dodiuk-Gad, R. P.

AU - Dominguez, A. R.

AU - Paller, A. S.

AU - Seminario-Vidal, L.

AU - Mostaghimi, A.

AU - Noe, M. H.

AU - Worswick, S.

AU - Tartar, D.

AU - Sheridan, R.

AU - Kaffenberger, B. H.

AU - Shinkai, K.

AU - Maverakis, E.

AU - French, L. E.

AU - Ingen-Housz-Oro, S.

PY - 2021/9

Y1 - 2021/9

N2 - Background: Supportive care is the cornerstone of management of adult and paediatric Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, consensus on the modalities of supportive care is lacking. Objectives: Our aim in this international multicentric Delphi exercise was to establish a multidisciplinary expert consensus to standardize recommendations regarding supportive care in the acute phase of SJS/TEN. Methods: Participants were sent a survey via the online tool SurveyMonkey, consisting of 103 statements organized into 11 topics: multidisciplinary team composition, suspect drug management, infection prevention, fluid resuscitation and prevention of hypothermia, nutritional support, pain and psychological distress management, management of acute respiratory failure, local skincare, ophthalmological management, management of other mucosa, and additional measures. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). The results were analysed according to the RAND/UCLA Appropriateness Method. Results: Forty-five participants from 13 countries (on three continents) participated. After the first round, a consensus was obtained for 82.5% of the 103 initially proposed statements. After the second round, a final consensus was obtained for 102 statements. Conclusions: We have reached an international Delphi-based consensus on best supportive care practice for SJS/TEN. Our expert consensus should help guide physicians in treating patients with SJS/TEN and thereby improve short-term prognosis and the risk of sequelae.

AB - Background: Supportive care is the cornerstone of management of adult and paediatric Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, consensus on the modalities of supportive care is lacking. Objectives: Our aim in this international multicentric Delphi exercise was to establish a multidisciplinary expert consensus to standardize recommendations regarding supportive care in the acute phase of SJS/TEN. Methods: Participants were sent a survey via the online tool SurveyMonkey, consisting of 103 statements organized into 11 topics: multidisciplinary team composition, suspect drug management, infection prevention, fluid resuscitation and prevention of hypothermia, nutritional support, pain and psychological distress management, management of acute respiratory failure, local skincare, ophthalmological management, management of other mucosa, and additional measures. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). The results were analysed according to the RAND/UCLA Appropriateness Method. Results: Forty-five participants from 13 countries (on three continents) participated. After the first round, a consensus was obtained for 82.5% of the 103 initially proposed statements. After the second round, a final consensus was obtained for 102 statements. Conclusions: We have reached an international Delphi-based consensus on best supportive care practice for SJS/TEN. Our expert consensus should help guide physicians in treating patients with SJS/TEN and thereby improve short-term prognosis and the risk of sequelae.

UR - http://www.scopus.com/inward/record.url?scp=85105369365&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85105369365&partnerID=8YFLogxK

U2 - 10.1111/bjd.19893

DO - 10.1111/bjd.19893

M3 - Article

C2 - 33657677

AN - SCOPUS:85105369365

SN - 0007-0963

VL - 185

SP - 616

EP - 626

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 3

ER -

Supportive care in the acute phase of Stevens–Johnson syndrome and toxic epidermal necrolysis: an international, multidisciplinary Delphi-based consensus

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this