Stevens-Johnson syndrome

Stevens-Johnson syndrome is a rare but serious disorder of the skin and mucous membranes. It is usually caused by a reaction or infection.

The syndrome often begins with flu-like symptoms followed by a painful red or purple rash that spreads over the skin and blisters. Then the topmost layer of the affected skin dies.

The syndrome is an emergency that requires hospitalization.

Treatment focuses on eliminating the underlying cause, controlling symptoms, and preventing complications.

Recovery from the disease can take weeks or months depending on the severity of the condition. If it was caused by drugs, it is necessary to stop taking them permanently.

What are the symptoms?

• Swelling of the face;
• Swelling of the tongue;
• Urticaria;
• Pain on the surface of the skin;
• A red or purple skin rash that spreads over several hours or up to several days.
• Blistering of the skin and mucous membranes of the mouth, nose, eyes and genitals.
• The shedding of the epidermis;< /p>

If you have developed the syndrome, a few days before the rash appears, the following initial signs may appear:

• Fever;
• Inflammation of the mouth and throat;
• Fatigue;
• Cough;
• Burning eyes;

When to seek emergency medical help?

• In case of swelling of the face;
• In case of unprovoked pain that is felt over a significant part of the skin surface;
• In case of swelling of the tongue;
• When hives develop;
• When the epidermis – the uppermost skin layer – begins to peel off.

What are the causes?

Steven-Johnson syndrome is a rare and unpredictable allergic reaction. The treating physician may not be able to determine the exact cause, but usually the clinical condition is due to the body’s reaction to medication or to an infection.

Medications and therapy that can cause the syndrome are:

Medications for gout such as allopurinol;
• Pain relievers such as acetaminophen, ibuprofen, naproxen sodium;
• Medicines to fight bacterial infections such as penicillin;
• Anticonvulsants and antipsychotics;
• Radiation therapy;

Infectious causes:

• Herpes – infection with herpes simplex or herpes zoster virus;
• Pneumonia;
• HIV;
• Hepatitis;

Treatment of Stevens-Johnson syndrome

The disease requires hospitalization, most often in an intensive care unit or a skin burn unit.
The first and most important step in treatment is to stop taking any medications that could be the cause of the severe allergic reaction.

Since it is difficult to determine in a short time which medication is the cause of the reaction, the attending physician may stop taking all medications that are not essential for the patient.

Supportive therapy

During hospitalization, therapy is administered to stabilize the patient’s condition, which most often consists of:
Fluid infusion and liquid nutrition– losing a piece of skin can lead to significant fluid loss from the body, so taking extra fluids is an important part of treatment. However, if the patient cannot take food and water by mouth, a tube is placed through the nose to the stomach /nasogastric tube/, through which fluids and nutrients are infused.
Care for the formed wounds on the skin – cool, moist compresses will help soothe the skin around the blisters while they heal.

Drug therapy

Pain relievers to relieve pain and discomfort;
• Medicines to soothe itchy skin – antihistamines;
Antibiotics when the cause of the disease is a bacterial infection.
• Medicines to reduce skin inflammation – topical steroids.

If the cause of the syndrome is found and accordingly removed or cured and the allergic reaction is stopped, new skin begins to form over the affected areas after a few days. In severe cases, recovery may take several months.

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