What criteria should I use to determine whether to refer a patient with SJS/TEN to secondary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Refer patients with Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN) to secondary care immediately. These conditions are classified as severe non-immediate cutaneous drug reactions requiring specialist management and hospital admission for acute treatment and monitoring.

Specifically, if a patient presents with suspected SJS or TEN, stop the suspected causative drug and arrange urgent referral to hospital for specialist care.

Document the suspected drug allergy in the patient's medical records and provide information about the reaction and drug avoidance.

Educational content only. Always verify information and use clinical judgement.