Question:medium
The patient came with a history of bullae involving > 30% of the body surface area along with erosions of the lips and other mucosae for the past 7 days. What is the most probable underlying etiology?
The patient came with a history of bullae involving > 30% of the body surface area along with erosions of the lips and other mucosae for the past 7 days. What is the most probable underlying etiology?
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Which is the commonest trigger of the SJS-TEN blistering spectrum?
Updated On: Jun 23, 2026
- Bacterial infection
- Viral infection
- Drugs
- Malignancy
Show Solution
The Correct Option is C
Solution and Explanation
Classify by area first: bullae and detachment over more than 30% of body surface plus mucosal erosions of the lips equals toxic epidermal necrolysis (Lyell's syndrome), the most severe form on the SJS-TEN spectrum. Recall the rule: < 10% is SJS, 10-30% overlap, > 30% is TEN.
Link to cause: the dominant trigger of this spectrum is drugs. The high-yield culprits are sulpha drugs, anticonvulsants (carbamazepine, lamotrigine, phenytoin), allopurinol and NSAIDs.
Weigh the alternatives: infections like Mycoplasma or herpes can occasionally set off SJS, mostly in children, but they are not the usual cause of TEN-range disease, and malignancy does not produce this acute blistering. The best single answer is drugs.
Ref: Standard dermatology texts.
Link to cause: the dominant trigger of this spectrum is drugs. The high-yield culprits are sulpha drugs, anticonvulsants (carbamazepine, lamotrigine, phenytoin), allopurinol and NSAIDs.
Weigh the alternatives: infections like Mycoplasma or herpes can occasionally set off SJS, mostly in children, but they are not the usual cause of TEN-range disease, and malignancy does not produce this acute blistering. The best single answer is drugs.
Ref: Standard dermatology texts.
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