Stevens Johnson Syndrome

Stevens-Johnson Syndrome, better known by its abbreviation in the medical world is an unusual but serious condition. It mainly affects the epidermis, mucous membranes, eyes, and genitals. SJS which generally occurs due to an unforeseeable and random adverse reaction of medication could erode at least 10% of the epidermis. Antiepileptic, NSAIDs, and antibiotics are the medications that make an individual most vulnerable to SJS.

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Stevens Johnson Syndrome Symptoms

Majority of the SJS patients suffer from skin pain. Initially, symptoms that are indicative of flu are present as well. These include:

  • Coughs
  • Pain in the joints
  • Nagging headaches
  • High body temperature, usually more than 38˚C (100.4˚F)
  • A feeling of sickness on the whole

Within a few days, rashes on the skin appear and become prominent. However, the rashes which rarely cause itching to proliferate within the course of a few hours or over the subsequent days. The outspread of rashes is soon followed by the emergence of blisters which upon bursting become sore, causing excruciating pain. Other signs and symptoms entail:

  • Swollen lips
  • Crusty sores on the face
  • Blisters and ulcerations on the mucous membranes lining the eyes, throat, genital tract, and mouth
  • Swallowing is difficult and painful because of the ulcers inside the mouth, and the affected individual could become dehydrated. People with SJS also experience issues with vision and may be vulnerable to corneal sores.

Managing Symptoms

  • To maintain mobility of your upper and lower limbs and to allay epidermal stiffening due to lying in bed for long hours, it is imperative to consult a therapist.
  • Take adequate rest.
  • The physician might suggest a medicinal mouthwash and a special toothbrush for managing the blisters inside the mouth and on the lips as well as checking further infection. The doctor will also show you how to brush your teeth or rinse your mouth.
  • For cleaning hairy skin areas, using baby shampoo is highly recommended Image Source:

Stevens Johnson Syndrome Causes

Adults are typically susceptible to SJS largely due to a specific medicine’s adverse reaction. Following are the names of some medicines that could most likely trigger Stevens-Johnson syndrome:

  • Phenytoin
  • Sertraline
  • Sulfamethoxazole
  • Sulfa antibiotics
  • Nevirapine
  • Allopurinol
  • Lamotrigine
  • Carbamazepine
  • NSAIDS (oxicam class)

Please note that individuals using the above medications have a slim chance of being diagnosed with SJS.

Children are susceptible to having SJS when they suffer from flu, mumps, cold sores (caused by Herpes simplex virus), glandular virus (Epstein-Barr virus), and Bornholm disease (Coxsackie virus). Alternatively, the risk of contracting SJS is comparatively low when children suffer from bacterial infections.

Stevens Johnson Syndrome Risk Factors

  • Family history: An individual is at greater risk of having SJS if someone from his or her immediate family or a close relative already has the disorder.
  • Previous episode or episodes: Individuals who have had SJS on an earlier occasion or occasions triggered by a specific medication could contract the syndrome in the future if they go back to using the same medication
  • Compromised immune system: Some treatments (chemotherapy for instance), autoimmune disorders (like SLE or rheumatoid arthritis), HIV associated neurocognitive disorders, and AIDS could weaken the immune system’s ability to combat diseases and disorders.
  • Viral afflictions: Herpes, HIV, pneumonia, flu, and hepatitis.

Stevens Johnson Syndrome Complications

  • Eye issues
  • Internal organs/visceral problems
  • Cellulitis
  • Abnormal skin growth

Stevens Johnson Syndrome Diagnosis

If you suspect that you may have SJS, you should seek professional help and advice from a dermatologist. The skin specialist usually makes a diagnosis on the basis of a physical examination, your medical history, and symptoms.

Nevertheless, biopsy of a tiny flake of skin is surely the best way to ascertain that you are suffering from the condition.

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Stevens Johnson Syndrome Treatment Options and Plans

Once it is confirmed via diagnosis that an adult or child has SJS, the individual needs to be admitted to a hospital immediately. Left untreated, the disorder could turn fatalistic. Those diagnosed with an acute form of the disorder are admitted in burns or ICU.

Discontinuing Medications

The attending physician or a team of medical specialists’ advise the nurse to stop offering all medications to the patient, excepting essential ones. It is very difficult to determine at the outset which particular medicine is activating the symptoms, hence the need to discontinue taking all medications.

Medications or Remedies that can help deal with SJS

A patient of SJS is usually recommended the following medications for dealing with and relieving the symptoms:

  • Moist, cold compress pressed firmly against the swollen areas of the skin
  • Powerful analgesics or painkillers
  • Replacement fluids
  • Application of a medicated moisturizer on the skin surface
  • Antiseptic/medicated mouthwashes
  • Eye ointment
  • Antibiotics (for dealing with septicemia in case it happens)
  • The temporary course of topical corticosteroids as prescribed by the specialist

The positive effects of treatment and medications will be confirmed with the growth of a new layer of the epidermis. The recovery period could vary from several weeks to months, depending upon the severity of the condition. The patient will have to stop taking the medication (that led to the outbreak of SJS) for once and for all.

However, the unpleasant response or reaction is not palpable or noticeable right after one takes medicine. It usually takes about 1-2 weeks for the symptoms to take effect in most of the cases while on a few occasions, the signs come to the fore after 1-2 months.

What to Visit A Doctor?

You should seek emergency care when:

  • You notice flaking of the skin that starts to peel and the skin aches on palpation
  • You find it difficult to breathe all of a sudden
  • Painful sores on the skin, eyes, genitals or mouth

You should get in touch with your healthcare provider if and when you:

  • Have a high fever more often
  • Observe sores inside the mouth after taking a new  medication
  • Have epidermal swelling, and it hurts

Stevens Johnson Syndrome Pictures

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