Immunomodulatory Systemic Therapies
Because the underlying cause of SJS and TEN is an overactive immune response, systemic therapies aimed at modulating this reaction are frequently employed. However, the use of these agents is the subject of ongoing clinical debate.
Common therapies include systemic corticosteroids, intravenous immunoglobulin, and certain immunosuppressants like cyclosporine. Corticosteroids are sometimes used in the very early stages to dampen inflammation, but their long-term use is often avoided due to the increased risk of infection and delayed wound healing.
Cyclosporine has shown promise in several studies for its ability to halt the progression of skin detachment and reduce the time to full re-epithelialization. It works by inhibiting specific immune cells that are thought to be responsible for the destruction of skin cells. Intravenous immunoglobulin is another option that may neutralize the signals that trigger cell death. More recently, biological agents that target specific inflammatory proteins, such as tumor necrosis factor-alpha, have been utilized with positive outcomes in some clinical settings. The choice of therapy often depends on the severity of the disease, the patient's underlying health status, and the specific institutional protocols.