Steven Johnson syndrome

Stevens Johnson syndrome is life-threatening skin disease that causes rash, skin peeling, and sores on the mucous membranes.

• Stevens-Johnson syndrome usually is caused by drugs or a bacterial infection.
• Typical symptoms for disease include fever, body aches, a flat red rash, blisters that break out on the mucous membranes, and small areas of peeling skin or large areas of peeling skin
• Affected people are hospitalized in a burn unit, given fluids and sometimes corticosteroids and antibiotics and all suspected drugs are stopped.

In Stevens-Johnson syndrome, a person has scorching of mucous membranes, characteristically in the mouth, eyes, and vagina, and patchy areas of rash. Bacterial infection is a cause of some cases, occasionally, a cause cannot be recognized. in all age groups this disorder occurs but more common in older people because they tend to use more drugs.

Symptoms:

If you have SJS, then you may experience several days before 

• Burning eyes
• Fever
• Sore throat
• Cough

Stevens-Johnson syndrome requires immediate medical attention. You should go to a doctor and seek emergency medical care if you experience any of the following signs or symptoms:

• A red or purple skin rash that spreads within hours to days
• Shedding (sloughing) of your skin
• Hives
• Facial swelling
• Tongue swelling
• Skin pain
• Blisters on your skin and mucous membranes, especially in your mouth, nose and eyes

Causes:

SJS is thought to occur due to a disorder of the immune system. The SJS is concerned with a variety of infectious and pharmacologic agents. There are two types of causes, the first is medication causes and second is Infectious causes.

Medication causes

• Anticonvulsants, which are used to treat seizures
• Sulfonamides and penicillins, which are used to treat infections
• Anti-gout medications, such as allopurinol
• Nonsteroidal anti-inflammatory drugs (NSAIDs)

Infectious causes

• Typhoid
• Hepatitis
• Herpes (herpes simplex or herpes zoster)
• Influenza
• HIV
• Diphtheria

Risk factors:

Cause can not be identified in approximately 50 percent of cases but Coxsackievirus, echovirus and most of herpes simplex viruses mycoplasma have precipitated the syndrome. Viral infections diseases decrease your immunity, and human immunodeficiency virus (HIV), systemic lupus erythematosus increase your risk of rising Stevens-Johnson syndrome.

Treatments:

Discontinue medication causes

An important step in treatment of SJS is discontinuing medication which may be causing it because it is difficult to find out the exact drug. Your doctor may advise that stop taking all nonessential medications.

Supportive care

Fluid replacement: Replacing fluids is an important part of treatment because skin loss can result in significant loss of fluid from your body.
Skin nursing: Damp compresses will help calm blisters while they cure. Health care team may gently remove any dead skin, and then place a dressing with a topical anesthetic over the affected areas, if needed.

Medications

Medications commonly used in the treatment of Stevens-Johnson syndrome.

• Antihistamines to relieve itching
• Antibiotics to control infection, when needed
• Pain medication to reduce discomfort
• Topical steroids to reduce skin inflammation

You may receive one of the following types of medications that are currently being studied in the treatment of Stevens-Johnson syndrome:

Intravenous corticosteroids: These drugs may reduce the severity of symptoms and shorten your recovery time
Immunoglobulin intravenous (IGIV): This medication contains antibodies that may help your immune system stop the progress of Stevens-Johnson syndrome.

Skin grafting

If a large area of your body is affected, skin grafting may be necessary to help you cure. This treatment is only rarely required.