30th July 2026

Aetiology

Medications remain the most common cause of SJS/TEN. The commonest causes are summarised in the table below:

Medications	Other causes
Anti-convulsants e.g. lamotrigine, carbamazepine, phenytoin, sodium valproate)	Epstein Barr Virus
Antibiotics e.g. minocycline, penicillin, cephalosporin quinolones	Herpes Simplex Virus
Aciclovir	Cytomegalovirus
Retinoids	Mycoplasma pneumonia
Anti-cancer drugs	Cancer
Biologic drugs	Vaccinations
Corticosteroids
Allopurinol
Contrast media
Sulfasalazine
Azathioprine
Non-steroidal anti-inflammatory drugs (NSAIDS)
Anti-HIV medications in particular nevirapine
Antifungals
Antimalarials

Table 3: Summary of causes of SJS/TEN

The exact mechanism of SJS/TEN is unknown but it is theorised to be an immunological reaction mediated by cytotoxic T-cells (CD8). The condition leads to the separation of the epidermis and papillary dermis at the epidermal-dermal junction with keratinocyte apoptosis.

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