Stevens-Johnson syndrome(SJS): Causes, Symptoms & Treatments
Stevens-Johnson syndrome is a serious skin disorder characterized by extensive necrosis and deprivation of the epidermis, usually caused by drugs. Stevens-Johnson syndrome is a relatively minor disease, which refers to the deprivation of less than 10% of the total body surface area. When more than 30% of the total body surface area is deprived, it is called a toxic epidermal necrosis.
Causes
The most common cause of Stevens-Johnson syndrome is medication. In general, allopurinol, aromatic anticonvulsant, antibacterial sulfonamide, lamotrigine, Nevirapine, and NSAIDs are thought to be the causative drugs. Especially in children, drugs such as antibacterial sulfonamide, phenobarbital, carbamazepine, lamotrigine and acetaminophen have been reported. Stevens-Johnson syndrome is common in infections of mycoplasma pneumonia and cytomegalovirus infection. Vaccination, systemic disease, contrast agent, chemical exposure, herbal medicines and food are also known to cause Stevens-Johnson syndrome.
Symptoms
Generally, a patient presents with a history of being exposed to drugs or suffering from other diseases. Acute-onset febrile illness or malaise may occur before skin lesions appear. Initially, erythematous macules, targetoid lesions or diffuse erythema appear, but vesicles and bullae form over time. The skin shows Nikolsky sign, which is a sign of peeling, and it can also penetrate the mucous membrane, so that abnormalities may also appear in mouth, eyes and genitalia.
Treatments
Treatment of Stevens-Johnson syndrome is basically the same as treatment in burns. Basically, it is necessary to supply sap and nourishment, and to maintain the balance of electrolyte in the body. Apply the patches and ointment to the affected area and remove the necrotic tissue. Oral lesions are required for ocular lesions. The use of steroids is still controversial but may be used with caution. Because the skin barrier is weakened, it should prevent secondary bacterial infection. Supportive care is also being carried out in patients with upper gastrointestinal bleeding as a way of adding other medicines whenever needed, based on fluid therapy and adjunctive therapy.
Causes
The most common cause of Stevens-Johnson syndrome is medication. In general, allopurinol, aromatic anticonvulsant, antibacterial sulfonamide, lamotrigine, Nevirapine, and NSAIDs are thought to be the causative drugs. Especially in children, drugs such as antibacterial sulfonamide, phenobarbital, carbamazepine, lamotrigine and acetaminophen have been reported. Stevens-Johnson syndrome is common in infections of mycoplasma pneumonia and cytomegalovirus infection. Vaccination, systemic disease, contrast agent, chemical exposure, herbal medicines and food are also known to cause Stevens-Johnson syndrome.
Symptoms
Generally, a patient presents with a history of being exposed to drugs or suffering from other diseases. Acute-onset febrile illness or malaise may occur before skin lesions appear. Initially, erythematous macules, targetoid lesions or diffuse erythema appear, but vesicles and bullae form over time. The skin shows Nikolsky sign, which is a sign of peeling, and it can also penetrate the mucous membrane, so that abnormalities may also appear in mouth, eyes and genitalia.
Treatments
Treatment of Stevens-Johnson syndrome is basically the same as treatment in burns. Basically, it is necessary to supply sap and nourishment, and to maintain the balance of electrolyte in the body. Apply the patches and ointment to the affected area and remove the necrotic tissue. Oral lesions are required for ocular lesions. The use of steroids is still controversial but may be used with caution. Because the skin barrier is weakened, it should prevent secondary bacterial infection. Supportive care is also being carried out in patients with upper gastrointestinal bleeding as a way of adding other medicines whenever needed, based on fluid therapy and adjunctive therapy.
