There are no specific recommendations, because the health status of each patient on discharge will determine further follow-up. Arrange patient follow-up visits at an outpatient clinic for check-ups and to monitor complications.[63]Creamer D, Walsh SA, Dziewulski P, et al. UK guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults 2016. Br J Dermatol. 2016 Jun;174(6):1194-227.
https://onlinelibrary.wiley.com/doi/10.1111/bjd.14530
http://www.ncbi.nlm.nih.gov/pubmed/27317286?tool=bestpractice.com
If there was ocular involvement, patients should be seen by an ophthalmologist; depending on any residual organ damage, they may need to be followed by a specialist such as a pulmonologist, nephrologist, allergist, gastroenterologist, or burn specialist.[2]Dodiuk-Gad RP, Chung WH, Valeyrie-Allanore L, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: an update. Am J Clin Dermatol. 2015 Dec;16(6):475-93.
http://www.ncbi.nlm.nih.gov/pubmed/26481651?tool=bestpractice.com
Female patients who have not yet reached menopause should follow up with a gynecologist and have a pelvic exam to rule out vaginal synechiae within a few months of hospital discharge. Undiagnosed, vaginal synechiae could impair sexual intercourse or normal vaginal delivery. Prevention of these complications is important.[2]Dodiuk-Gad RP, Chung WH, Valeyrie-Allanore L, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: an update. Am J Clin Dermatol. 2015 Dec;16(6):475-93.
http://www.ncbi.nlm.nih.gov/pubmed/26481651?tool=bestpractice.com
[107]Kaser DJ, Reichman DE, Laufer MR. Prevention of vulvovaginal sequelae in Stevens-Johnson syndrome and toxic epidermal necrolysis. Rev Obstet Gynecol. 2011 Summer;4(2):81-5.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218548
http://www.ncbi.nlm.nih.gov/pubmed/22102931?tool=bestpractice.com
Patients who have difficulty swallowing or mucositis should be seen by an otolaryngologist.[2]Dodiuk-Gad RP, Chung WH, Valeyrie-Allanore L, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: an update. Am J Clin Dermatol. 2015 Dec;16(6):475-93.
http://www.ncbi.nlm.nih.gov/pubmed/26481651?tool=bestpractice.com
Patients can develop limitations in mobility with decreased strength. Arrange for daily exercises within the patient's capability with a physical therapist and, if needed, an occupational therapist.
The National Institutes of Health Working Group has created a case report form for SJS/TEN to help standardize the documentation of individual cases.[111]Maverakis E, Wang EA, Shinkai K, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis standard reporting and evaluation guidelines: results of a National Institutes of Health Working Group. JAMA Dermatol. 2017 Jun 1;153(6):587-92.
http://www.ncbi.nlm.nih.gov/pubmed/28296986?tool=bestpractice.com