The Role of a Multidisciplinary Team in SJS/TEN Care

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare but extremely serious conditions often triggered by medications. These severe drug reactions can cause widespread skin detachment and mucosal damage, resembling second-degree burns. However, what many people don’t realize is that SJS and TEN affect far more than just the skin. These conditions can damage multiple internal organs, making treatment complex and demanding. That’s where a multidisciplinary team comes in.

In the early stages of SJS/TEN, identifying and discontinuing the causative drug is the most urgent priority. Once this is done, patients need immediate transfer to a specialized burn center or intensive care unit, where they can receive care from a coordinated team of medical professionals. This multidisciplinary approach has become the cornerstone of modern SJS/TEN management.

Why a Team Approach Matters

SJS/TEN can impact the lungs, gastrointestinal tract, liver, kidneys, eyes, genitalia, and more. Because no single doctor can manage all these complications alone, an effective team often includes:

• Dermatologists to diagnose and monitor the skin reaction.

• Burn surgeons and wound care nurses to manage the open skin lesions like burn wounds.

• Ophthalmologists to address eye involvement, which can lead to scarring or vision loss if untreated.

• Gynecologists or urologists to treat mucosal involvement in the genital or urinary tracts.

• Internal medicine specialists and intensivists to monitor and manage systemic symptoms, fluid balance, infections, and organ support.

• Dieticians to ensure adequate calorie and protein intake during the body’s healing process.

• Psychologists and social workers to support patients’ mental health and recovery.

• Pharmacists to assist in identifying the causative drug, recommending safe alternatives, and managing complex medication regimens during recovery.

According to Canadian and international studies, patients managed in burn units by teams that include dermatologists, intensivists, plastic surgeons, and others have better outcomes—including lower mortality and fewer long-term complications.

What Does Care Look Like in Practice?

In the hospital, the team will work together to monitor for and prevent complications. Burn nurses provide gentle dressing changes with non-stick materials that don’t damage fragile healing skin. Pain specialists help manage the significant discomfort that patients experience. Ophthalmologists might use lubricating eye drops or perform procedures to prevent long-term eye damage. Internists carefully balance IV fluids, electrolytes, and nutrition while watching for infections, organ dysfunction, and sepsis.

Each specialty plays a unique but interconnected role. Without this coordination, vital complications—such as respiratory issues or genital scarring—can go unnoticed or untreated. Unfortunately, many SJS/TEN survivors who do not receive comprehensive care report long-term complications like vision loss, sexual dysfunction, chronic fatigue, and emotional trauma.

What Happens After Hospital Discharge?

Recovery from SJS/TEN doesn’t end when the skin heals. Survivors often face physical, emotional, and psychological challenges. A multidisciplinary follow-up team may include dermatology, ophthalmology, psychiatry, and physical therapy. Patients may also need ongoing wound care and rehabilitation. That’s why education, communication, and long-term planning are essential parts of the discharge process.

Conclusion

SJS and TEN are not just skin diseases—they are complex, systemic conditions that require more than a one-size-fits-all approach. A multidisciplinary team is essential not only for survival during the acute phase, but also for minimizing long-term complications and restoring quality of life. Whether it’s saving someone’s sight, preventing kidney failure, or supporting mental health, each team member plays a crucial role.

Together, they make the difference between surviving SJS/TEN—and truly healing from it.

REFERENCES

1. Martinez Villarreal, J. D., Cardenas-de la Garza, J. A., Ionescu, M. A., et al. (2025). Stevens‐Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Current Management and Innovative Therapies. International Journal of Dermatology, 64(7), 1164–1172. https://doi.org/10.1111/ijd.17768

2.  Surowiecka, A., Barańska-Rybak, W., & Strużyna, J. (2023). Multidisciplinary Treatment in Toxic Epidermal Necrolysis. International Journal of Environmental Research and Public Health, 20(3), 2217. https://doi.org/10.3390/ijerph20032217

3. Papp, A., Sikora, S., Evans, M., et al. (2018). Treatment of Toxic Epidermal Necrolysis by a Multidisciplinary Team: A Review of Literature and Treatment Results. Burns, 44(4), 807–815. https://doi.org/10.1016/j.burns.2017.10.022

4. Shanbhag, S. S., Chodosh, J., Fathy, C., et al. (2020). Multidisciplinary Care in Stevens-Johnson Syndrome. Therapeutic Advances in Chronic Disease, 11, 2040622319894469. https://doi.org/10.1177/2040622319894469