STEVENS-JOHNSON SYNDROME

STEVENS-JOHNSON SYNDROME-All you  need to know

Edited by, SOWNDHARYA

Stevens-Johnson syndrome (SJS) is a rare, serious disorder of the skin and mucous membranes. It's usually a reaction to medication that starts with flu-like symptoms, followed by a painful rash that spreads and blisters. Then the top layer of affected skin dies, sheds and begins to heal after several days.

It is a medical emergency that usually requires hospitalization. Treatment focuses on removing the cause, caring for wounds, controlling pain and minimizing complications as skin regrows. It can take weeks to months to recover.

SYMPTOMS: 

One to three days before a rash develops the person may show early signs of Stevens-Johnson syndrome, including: 

• Fever

• A sore mouth and throat

• Fatigue

• Burning eyes

As the condition develops, other signs and symptoms include:

• Unexplained widespread skin pain

• A red or purplish rash that spreads

• Blisters on your skin and the mucous membrane of the mouth, nose, eyes and genitals

• Shedding of skin within days after blisters form

WHEN TO SEE A DOCTOR?

SJS requires immediate medical attention. Seek emergency medical care if the person experience signs and symptoms of this condition. Drug-induced reactions may occur during the use of a medication or up to two weeks after discontinuing it.

CAUSES: 

Stevens-Johnson syndrome is a rare and unpredictable illness. The doctor may not be able to identify its exact cause, but usually the condition is triggered by medication, an infection or both. The patient may react to medication while they're using it or up to two weeks after they're stopped using it.

Drugs that can cause Stevens-Johnson syndrome include:

• Anti-gout medications, such as allopurinol
• Anticonvulsants and antipsychotics
• Antibacterial sulfonamides (including sulfasalazine)
• Nevirapine
• Pain relievers, such as acetaminophen, ibuprofen and naproxen sodium

Infections that can cause Stevens-Johnson syndrome include pneumonia and HIV.

RISK FACTORS

Factors that increase the risk of developing Stevens-Johnson syndrome include:

• An HIV infection: Among people with HIV, the incidence of Stevens-Johnson syndrome is about 100 times greater than among the general population.
• A weakened immune system: The immune system can be affected by an organ transplant, HIV/AIDS and autoimmune diseases.
• Cancer: People with cancer, particularly blood cancer, are at increased risk of Stevens-Johnson syndrome.
• A history of Stevens-Johnson syndrome.

COMPLICATIONS

Steven-Johnson syndrome complications include:

• Dehydration: Areas where the skin has shed lose fluids. And sores in the mouth and throat can make fluid intake difficult, resulting in dehydration.
• Sepsis occurs when bacteria from an infection enter your bloodstream and spread throughout your body. Sepsis is a rapidly progressing, life-threatening condition that can cause shock and organ failure.
• Eye problems: The rash caused by Stevens-Johnson syndrome can lead to eye inflammation, dry eye and light sensitivity. In severe cases, it can lead to visual impairment and, rarely, blindness.
• Lung involvement: The condition may lead to acute respiratory failure.
• Permanent skin damage: When your skin grows back following Steven-Johnsons syndrome, it may have abnormal bumps and coloring.