Introduction
Toxic epidermal necrolysis (TEN) and Steven–Johnson syndrome (SJS) are rare but life-threatening mucocutaneous conditions induced by immune system activation mostly caused by certain drugs and their metabolites, Associated with widespread keratinocyte death causing full-thickness denudation of the skin and mucosa, which results in a high susceptibly to sepsis with a mortality rate of 30% (1) . The cutaneous and mucosal manifestations are commonly preceded by many non-specific symptoms including fever, rhinitis, headache, conjunctivitis and sore throat lasting approximately one week . Complications include infections, eye involvement (potentially leading to blindness) , scars involving the mouth, pharynx, oesophagus, rectus, middle airways and genitourinary tract (phimosis, vaginal stenosis, dysuria) . Other deadly complications include renal and/or hepatic failure, dehydration, and sepsis (2) . There are two entities of the same clinical condition differing only in their percentage involved in their body surface. The percentage of the body surface involved is the only difference between SJS and TEN. Where, body surface area (<10%) involvement is reported in SJS, 10-30% BSA in SJS-TEN overlap and >30% BSA detachment is reported in TEN(3) . The most common trigger for TEN/SJS are medications and usually triggers the disease within 8 weeks in both adults and children; however, the typical exposure period ranges from 4 days to 4 weeks. Commonly accused medications include non-steroidal anti-inflammatories, allopurinol, anticonvulsants such as lamotrigine, phenytoin and carbamazepine, antibacterial sulphonamides and the antiretroviral nevirapine (3) .