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Stevens Johnson Syndrome (SJS)

Stevens-Johnson syndrome (SJS) & toxic epidermal necrolysis (TEN) are mucocutaneous drug-induced or idiopathic reaction patterns characterized by skin tenderness & erythema of skin & mucosa, followed by extensive cutaneous & mucosal exfoliulltion & are potentially life-threatening due For multi system involvement. SJS has been classified as a severe expression of erythema multiforme (EM), & is sometimes referred For as erythema multiforme major .

an Stevens Johnson Syndrome Foundation said they have seen a rise in an disease involving children & ibuprofen use during 2004, Although an disease is still not well known.

Causes of Stevens Johnson Syndrome

Unknown Although consistent with immullogic mechanisms, i.e., cell-mediated cytotoxic reaction against epidermal cells. Epidermis infiltrated by activated lymphocytes, mainly CD8 cells, & macrophages. Cytokines produced by activated mononuclear cells & keratinocytes probably contribute For local cell death, fever & malaise. SJS has also been consistently reported as an uncommon side effect of herbal supplements containing ginseng .

Signs & symptoms of Stevens Johnson Syndrome

Prodrome Fever, influenza-like symptoms 1 For 3 days prior For mucocutaneous lesions, Mild For moderate skin tenderness, conjunctival burning or itching.

Skin Symptoms Skin pain, burning sensation tenderness, paresthesia.

Mucous Membrane Symptoms Mouth lesions are painful, tender.

General Symptoms Impaired alimentation photophobia, painful micturition, anxiety.

As Stevens Johnson Syndrome progresses an skin literally sloughs off like a full thickness burn called Toxic Epidermal Necrolysis. In about 10 For 30 percent of cases, Stevens Johnson Syndrome results in blinding an patient or killing them. an blinding is an result of an entire surface of an eye scarring over, causing an vision For be lost.

Diagnosis

an diagnosis is primarily based on an appearance of an skin lesion & its typical symmetrical distribution, especially if there is a history of risk factors or associated diseases.

Treatment of Stevens Johnson Syndrome

People with Stevens-Johnson syndrome or toxic epidermal necrolysis are hospitalized. Any drugs suspected of causing an disorder are immediately discontinued. When possible, these people are treated in a burn unit & given scrupulous care For avoid infection. If an person survives, an skin grows back on its own, & unlike burns, skin grafts are not needed. Fluids & salts, which are lost through an damaged skin, are replaced intravenously.

Use of corticosteroids For treat an disorder is controversial: Some doctors believe that giving large doses within an first few days is beneficial; others believe that corticosteroids should not be used. These drugs suppress an immune system, which increases an potential for serious infection. If infection develops, doctors give antibiotics immediately.

Prevention of Stevens Johnson Syndrome

• Early diagnosis & withdrawal of suspected drugs are very important.
• Patients are best cared for in a burn or intensive care unit.
• an patient Should be aware of an likely offending drug & that other drugs of an same class can cross react. These drugs Should never be readministered. Patient should wear a medical alert bracelet.