ABSTRACT Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, life‐threatening mucocutaneous reactions. Pediatric mortality is lower than in adults, but children face higher risks of recurrence and long‐term sequelae. Despite disease severity, pediatric‐specific guidelines remain scarce and often extrapolated from adult populations. We systematically reviewed and appraised national and international clinical practice guidelines and consensus statements on pediatric SJS/TEN, focusing on supportive care, pharmacologic interventions, mucosal management, and long‐term follow‐up. A systematic search of MEDLINE, Embase, PubMed, CENTRAL, Scopus, and CINAHL (January 2000–April 2025) identified national and international guidelines. For feasibility, we restricted full appraisal to documents published in English or French. Eligible documents provided explicit recommendations for patients < 18 years. Two reviewers independently extracted data and assessed quality using the AGREE II instrument. Of 144 records screened, 10 guidelines met inclusion criteria; 60% were published within the last 5 years, and 50% were consensus‐based without systematic evidence synthesis. Most (90%) endorsed supportive measures such as wound care, nutritional support, and fluid resuscitation. Recommendations for pharmacologic therapy varied considerably: intravenous immunoglobulin (50%), systemic corticosteroids (40%), and cyclosporine (40%), with limited pediatric dosing guidance. Only one guideline mentioned biologics. Multidisciplinary care was recommended in 90%, yet long‐term follow‐up for sequelae appeared in only 50%. AGREE II appraisal showed high clarity of presentation but consistently low applicability; only the British Association of Dermatologists guideline achieved high quality across all domains. Current pediatric SJS/TEN guidelines display heterogeneity in scope and rigor. While supportive care is emphasized, pharmacologic and long‐term management guidance remains inconsistent. Standardized, evidence‐based, pediatric‐specific guidelines are urgently needed.
Creighton et al. (Mon,) studied this question.