Stevens-Johnson Syndrome

(SJS)
  • Definition

    Stevens-Johnson Syndrome (SJS) is a severe illness associated with fever and skin problems including rash, blisters, and ulcers. Although it can affect skin all over the body, a trademark of SJS are problems of the skin inside the mouth, nose, and eyes.
    Blisters
    IMAGE
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  • Causes

    SJS is caused by an overreaction of the immune system to certain medications. It is not certain what causes the overreaction but it may be linked to genetic factors.
  • Risk Factors

    Medications that are most often associated with SJS include:
    • Sulfonamides
    • Aminopenicillins
    • Quinolones
    • Cephalosporins
    • Tetracyclines
    • Imidazole antifungals
    • Aromatic anticonvulsants
    Other factors that may increase your risk of SJS include:
    • Diseases that decrease your immunity like HIV and systemic lupus erythematosus
    • Certain genes
    • Radiation therapy and taking anti-seizure medication to treat a brain tumor
    • Certain infections such as
      • Herpes
      • Influenza
      • Diphtheria
      • Typhoid
      • Hepatitis
  • Symptoms

    SJS symptoms progress over time. Early symptoms may include:
    • Fever
    • Sore throat
    • Cough
    • Burning eyes
    After several days, the following symptoms may occur:
    • A red or purple rash that spreads
    • Swelling of the face and tongue
    • Skin pain
    • Blisters on the skin and the skin inside the mouth, nose, and eyes
    • Shedding of the skin
  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. This will often result in a diagnosis.
    A sample of skin may be tested. This can be done with a biopsy.
  • Treatment

    Talk with your doctor about the best treatment plan for you. You may be referred to a specialist for treatment depending on your symptoms.
    Treatment options include:
    Medications
    Your doctor may advise you to stop taking medications that may be causing the condition.
    If not related to your symptoms, you may be given:
    • Pain medication to reduce discomfort
    • Antihistamines to reduce itching
    • Antibiotics to treat an infection caused by bacteria
    • Antiviral medications to treat an infection caused by viruses
    • Topical steroids to reduce swelling
    • IV immunoglobulin (IVIG)
    Fluid Replacement
    You may be given IV fluids at the hospital to replace lost fluids.
    Skin Treatments
    Treatments for the skin may include:
    • Applying cool, wet compresses to blisters
    • Removing dead skin
    • Wound care
  • Prevention

    To help reduce your chance of getting SJS, avoid taking the medications that cause SJS to occur.
  • RESOURCES

    Johns Hopkins Medicine http://www.hopkinsmedicine.org

    Shriners Hospitals for Children http://www.shrinershospitalsforchildren.org

    CANADIAN RESOURCES

    Canadian Dermatology Association http://www.dermatology.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Stevens-Johnson syndrome. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/wilmer/conditions/stevens-johnson.html. Accessed October 3, 2013.

    Stevens-Johnson syndrome. Patient UK website. Available at: http://www.patient.co.uk/doctor/stevens-johnson-syndrome. Updated November 2, 2012. Accessed October 3, 2013.

    Stevens-Johnson syndrome. Shriners Hospitals for Children website. Available at: http://www.shrinershospitalsforchildren.org/en/CareAndTreatment/Burns/Stevens-JohnsonSyndrome.aspx. Accessed October 3, 2013.

    Stevens-Johnson Syndrome/toxic epidermal necrolysis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 17, 2011. Accessed October 3, 2013.

    Revision Information

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