| Keywords [eng] |
LT: klinikinis valdymas, dermatologinės ekstremalios situacijos, diagnostikanekrotizuojantis fascitas, Stivenso–Džonsono sindromas, sisteminė apžvalga, gydymas, toksinė epiderminė nekrolizė ENG: Clinical management, Dermatological emergencies, Diagnosis, Necrotising fasciitis, Stevens–Johnson syndrome, Systematic review, Treatment, Toxic epidermal necrolysis |
| Abstract [eng] |
Background/Introduction: Critical dermatological emergencies such as necrotising fasciitis (NF), toxic epidermal necrolysis (TEN), and Stevens–Johnson syndrome (SJS) represent severe, rapidly progressing conditions that require urgent recognition and clinical management. Despite this, early diagnosis remains a challenge, as these disorders often mimic more common dermatological or infectious presentations, leading to delay in appropriate treatment. A thorough understanding of their epidemiology, clinical features, diagnostic approaches, and treatment strategies is essential for improving patient outcomes and guiding clinicians in emergency and inpatient care settings. However, existing literature is widely dispersed and varies in quality, making it necessary to synthesise current evidence to support effective clinical decision-making. Aim and Objectives: This systematic review aimed to evaluate and summarise the current evidence on the epidemiology, clinical presentation, diagnosis, treatment, and outcomes of NF, SJS, and TEN, in order to support timely recognition and effective clinical decision-making. Materials and Methods: A systematic literature search was conducted in PubMed using relevant Medical Subject Headings (MeSH terms) and text-words, restricted to English-language articles published within the last 15 years. After duplicate removal, studies underwent a two-phase screening process according to PRISMA guidelines: initial title and abstract screening, followed by full-text evaluation based on predefined inclusion and exclusion criteria. Extracted data included epidemiology, clinical presentation, diagnostics, treatments, and outcomes. Results: In total, 38 studies have met the eligibility criteria. Across the literature, NF, SJS, and TEN were consistently associated with rapid progression, diagnostic challenges, and high morbidity and also mortality. Early recognition and the timely intervention, particularly prompt surgical management in NF and early withdrawal of causative drugs in SJS/TEN, were repeatedly shown to improve the outcomes. Despite variability in assessment and treatment strategies, multidisciplinary and supportive care remained essential components of effective management. Conclusion: This review demonstrates that NF, SJS, and TEN remain severe dermatological emergencies in which delayed recognition significantly worsens patient outcomes. Although the included studies has presented varied diagnostic and treatment approaches, early identification, and timely intervention, and the coordinated multidisciplinary care were consistently associated with improved prognosis. The findings highlight the continued need for heightened clinical awareness, standardised diagnostic strategies, and evidence-based management protocols to support effective decision-making in these rapidly progressing conditions. Keywords: Clinical management, Dermatological emergencies, Diagnosis, Necrotising fasciitis, Stevens–Johnson syndrome, Systematic review, Treatment, Toxic epidermal necrolysis. |
