FIGURE 68.11 Hemorrhagic crust and erosions on the lip after desquamation (Reprinted with permission from Onofrey BE, Skorin L, Holdeman NR Ocular Therapeutics Handbook Philadelphia, PA: Lippincott Williams & Wilkins; 2011.) Drugs are the most common trigger for SJS/TEN Antibiotics (trimethoprimsulfamethoxazole, minocycline), antiepileptics (carbamazepine, phenytoin, phenobarbital, lamotrigine), NSAIDs, and nevirapine are frequent triggers for SJS/TEN The first signs of SJS/TEN can present approximately to 21 days after starting the medication Similar to DHR, a genetic predisposition for SJS/TEN development may be present Since the identification of the association between HLA-B*1502 and carbamazepine-induced SJS/TEN in patients of East Asian descent, the Food and Drug Administration recommends HLA-B*1502 testing prior to carbamazepine initiation Similarly, HLA-B*5801 has been associated with allopurinol hypersensitivity and HLA-B*5701 has been associated with abacavir hypersensitivity A mucosal predominant form of SJS associated with mycoplasma infection was recently renamed Mycoplasma pneumoniae– induced rash and mucositis (MIRM) Mucositis is a prominent feature of MRIM, though the cutaneous involvement is absent or minimal As a result, the clinical course of MRIM is milder than SJS/TEN MIRM-like reactions have also been reported with influenza and Chlamydia pneumoniae infection Early MRIM may be difficult to