<unk>  is thought to arise from a disorder of the immune system. The immune reaction can be triggered by drugs or infections. Genetic factors are associated with a predisposition to<unk> . The cause of<unk>  is unknown in one-quarter to one-half of cases.<unk> ,<unk> /TEN, and TEN are considered a single disease with common causes and mechanisms. Individuals expressing certain human leukocyte antigen (i.e. HLA) serotypes (i.e. genetic alleles), genetical-based T cell receptors, or variations in their efficiency to absorb, distribute to tissues, metabolize, or excrete (this combination is termed ADME) a drug are predisposed to develop<unk> . Medications Although<unk>  can be caused by viral infections and malignancies, the main cause is medications. A leading cause appears to be the use of antibiotics, particularly sulfa drugs. Between 100 and 200 different drugs may be associated with<unk> . No reliable test exists to establish a link between a particular drug and<unk>  for an individual case. Determining what drug is the cause is based on the time interval between first use of the drug and the beginning of the skin reaction. Drugs discontinued more than 1 month prior to onset of mucocutaneous physical findings are highly unlikely to cause<unk>  and TEN.<unk>  and TEN most often begin between 4 and 28 days after culprit drug administration. A published algorithm (ALDEN) to assess drug causality gives structured assistance in identifying the responsible medication.<unk>  may be caused by the medications rivaroxaban, vancomycin, allopurinol, valproate, levofloxacin, diclofenac, etravirine, isotretinoin, fluconazole, valdecoxib, sitagliptin, oseltamivir, penicillins, barbiturates, sulfonamides, phenytoin, azithromycin, oxcarbazepine, zonisamide, modafinil, lamotrigine, nevirapine, pyrimethamine, ibuprofen, ethosuximide, carbamazepine, bupropion, telaprevir, and nystatin. Medications that have traditionally been known to lead to<unk> , erythema multiforme, and toxic epidermal necrolysis include sulfonamide antibiotics, penicillin antibiotics, cefixime (antibiotic), barbiturates (sedatives), lamotrigine, phenytoin (e.g., Dilantin) (anticonvulsants) and trimethoprim. Combining lamotrigine with sodium valproate increases the risk of<unk> . Nonsteroidal anti-inflammatory drugs (NSAIDs) are a rare cause of<unk>  in adults; the risk is higher for older patients, women, and those initiating treatment. Typically, the symptoms of drug-induced<unk>  arise within a week of starting the medication. Similar to NSAIDs, paracetamol (acetaminophen) has also caused rare cases of<unk> . People with systemic lupus erythematosus or HIV infections are more susceptible to drug-induced<unk> . Infections The second most common cause of<unk>  and TEN is infection, particularly in children. This includes upper respiratory infections, otitis media, pharyngitis, and Epstein–Barr virus, Mycoplasma pneumoniae and cytomegalovirus infections. The routine use of medicines such as antibiotics, antipyretics and analgesics to manage infections can make it difficult to identify if cases were caused by the infection or medicines taken. Viral diseases reported to cause<unk>  include: herpes simplex virus (possibly; is debated), AIDS, coxsackievirus, influenza, hepatitis, and mumps. In pediatric cases, Epstein-Barr virus and enteroviruses have been associated with<unk> . Recent upper respiratory tract infections have been reported by more than half of patients with<unk> . Bacterial infections linked to<unk>  include group A beta-hemolytic streptococci, diphtheria, brucellosis, lymphogranuloma venereum, mycobacteria, Mycoplasma pneumoniae, rickettsial infections, tularemia, and typhoid. Fungal infections with coccidioidomycosis, dermatophytosis and histoplasmosis are also considered possible causes. Malaria and trichomoniasis, protozoal infections, have also been reported as causes.
Stevens–Johnson syndrome
Staphylococcal scalded skin syndrome
Chickenpox
Streptococcal intertrigo
Skin condition
Johnson–Munson syndrome
Staphylococcal infection
Acute cutaneous lupus erythematosus