Supplemental materials for publication “Distinguishing Stevens-Johnson syndrome/toxic epidermal necrolysis from clinical mimickers during inpatient dermatologic consultation – a retrospective chart review.” JAAD. 2019.

Published: 26 June 2019| Version 1 | DOI: 10.17632/kzm64tt5k7.1
Allison Weinkle, Cory Pettit, Aditi Jani, Jesse Keller, Yuanyuan Lu, Stephen Malachowski, John Trinidad, Benjamin Kaffenberger, Elizabeth Ergen, Lauren Hughey, David Smith, Lucia Seminario-Vidal


Statistical analysis here replicates that performed in the primary manuscript with addition of mucosal involvement (either present or absent) as reported in Supplemental Table 1. Stepwise regression of all significant variables including mucosal involvement yielded an updated model with four predictor variables. A new multivariable model was fit with Nikolsky sign (adjusted OR 49.0, 95% CI 10.6-226.2, p-value <0.001); atypical targets (adjusted OR 26.5, 95% CI 5.5-127.3, p<0.001); fever (adjusted OR 7.6, 95% CI 1.8-33.0, p-value=0.007); mucosal involvement (adjusted OR 21.3, 95% CI 4.1-110.7, p-value <0.001); OR (odds ratio); CI (confidence interval). This new multivariable model for the probability of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is defined as indicated in Supplemental Figure 1. This updated model yields a 91.5% sensitivity and 94.6% specificity with a corresponding positive and negative predictive values of 87.1% and 96.6%, respectively. The AUC for the final model is 0.98 (95% confidence interval 0.96, >0.99 and p-value<0.001). Supplemental Figure 2 is a nomogram which provides the relative contributions of each predictor, including mucosal involvement, to the probability of SJS/TEN.



Dermatology, Drug, Steven-Johnson Syndrome, Acute Generalized Exanthematous Pustulosis, Drug Hypersensitivity, Erythema Multiforme, Inpatient, Toxic Epidermal Necrolysis