Are steroids effective in toxic epidermal necrolysis and Stevens-Johnson syndrome?

Toxic epidermal necrolysis and Stevens-Johnson syndrome are severe adverse skin reactions to medications and infections. Steroids are described as a therapeutic alternative, but their use is still controversial. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple information sources. We identified four systematic reviews including 11 primary studies answering the question of interest. We extracted data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded it is not clear whether steroids reduce mortality or hospital stay in toxic epidermal necrolysis and Stevens-Johnson syndrome because the certainty of the evidence is very low.