Physical:
The rash can begin as macules that develop into papules, vesicles, bullae, urticarial plaques, or confluent erythema.
The center of these lesions may be vesicular, purpuric, or necrotic.
The typical lesion has the appearance of a target. The target is considered pathognomonic.
Lesions may become bullous and later rupture, leaving denuded skin. The skin becomes susceptible to secondary infection.
Urticarial lesions typically are not pruritic.
Infection may be responsible for the scarring associated with morbidity.
Although lesions may occur anywhere, the palms, soles, dorsum of hands, and extensor surfaces are most commonly affected.
The rash may be confined to any one area of the body, most often the trunk.
Mucosal involvement may include erythema, edema, sloughing, blistering, ulceration, and necrosis.
Although some have suggested the possibility of SJS without skin lesions, most believe that mucosal lesions alone are not enough to establish the diagnosis.
The following signs may be noted on examination:
Fever
Orthostasis
Tachycardia
Hypotension
Altered level of consciousness
Epistaxis
Conjunctivitis
Corneal ulcerations
Erosive vulvovaginitis or balanitis
Seizures, coma
