Stevens johnson syndrome

Stevens-Johnson syndrome

1. Stevens-Johnson syndrome By, Ms. Ekta S Patel, Assistant Professor.

2. Introduction: Stevens-Johnson syndrome is a rare, serious disorder of your skin and mucous membranes. It's usually a reaction to a medication or an infection.

3. Often, it begins with flu-like symptoms, followed by a painful red or purplish rash that spreads and blisters. Then the top layer of the affected skin dies, sheds and then heals .

4. Stevens-Johnson syndrome is a medical emergency that usually requires hospitalization. Treatment focuses on eliminating the underlying cause, controlling symptoms and minimizing complications as skin regrows .

5. Recovery after Stevens-Johnson syndrome can take weeks to months, depending on the severity of condition . If it was caused by a medication, need to permanently avoid that drug and others closely related to it .

6. Definition A systemic skin disease, probably identical to toxic epidermal necrolysis , that produces fever and lesions of the oral, conjunctival , and vaginal mucous membranes. It is marked by a cutaneous rash that is often widespread and severe. Skin loss may lead to dehydration, infection, or death.

7. Causes:

8. Medication and therapy causes Anti-gout medications, such as allopurinol Medications to fight infection, such as penicillin Pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) Medications to treat seizures and mental illness (anticonvulsants and antipsychotics), with added risk if also undergo radiation therapy;

9. Infectious causes Herpes virus (herpes simplex or herpes zoster) Pneumonia ( M ycoplasma pneumoniae ) HIV Hepatitis A

10. signs and symptoms Fever Unexplained widespread skin pain A red or purple skin rash that spreads Blisters on skin and the mucous membranes of mouth, nose, eyes and genitals Shedding of skin within days after blisters form

11. If patient has Stevens-Johnson syndrome, several days before the rash develops he may experience: Fever Sore mouth and throat Fatigue Cough Burning eyes

12. Diagnostic Evaluation: Physical exam. Doctors often can identify Stevens-Johnson syndrome based on medical history and a physical exam. Skin biopsy. To confirm the diagnosis, and rule out other possible causes, doctor may remove a sample of skin for laboratory testing (biopsy ).

13. Culture. Skin or oral culture or culture from other areas may be taken to confirm or rule out infection. Imaging. Depending on symptoms , doctor may have you undergo a chest X-ray to check for pneumonia. Blood tests. These are used to confirm infection or other possible causes.

14. Treatment Stevens-Johnson syndrome requires hospitalization, often in an intensive care unit or a burn unit .

15. Stopping nonessential medications The first and most important step in treating Stevens-Johnson syndrome is to discontinue any medications that may be causing it.

16. Supportive care Supportive care while hospitalizion includes: Fluid replacement and nutrition. Because skin loss can result in significant loss of fluid from body , replacing fluids is an important part of treatment.

17. Wound care. Cool, wet compresses will help soothe blisters while they heal. Eye care.

18. Medications Pain medication to reduce discomfort. Medication to reduce inflammation of the eyes and mucous membranes (topical steroids). Antibiotics to control infection, when needed.

19. Depending on the severity, other systemic medications can be considered, including oral steroids, immune globulin and other immune-related treatments.

20. Complications Secondary skin infection ( cellulitis ). Cellulitis can lead to life-threatening complications, including sepsis. Blood infection (sepsis). Sepsis occurs when bacteria from an infection enter bloodstream and spread throughout body. Sepsis is a rapidly progressing, life-threatening condition that can cause shock and organ failure .

21. Lung involvement. The condition may lead to acute respiratory failure. Permanent skin damage. When skin grows back following Stevens-Johnson syndrome, it may have abnormal bumps and coloring . And may have scars. Lasting skin problems may cause your hair to fall out, and fingernails and toenails may not grow normally.

22. Eye problems. The rash caused by Stevens-Johnson syndrome can lead to inflammation in eyes. In mild cases, this may cause irritation and dry eyes. In severe cases, it can lead to extensive tissue damage and scarring that results in visual impairment and, rarely, blindness.