Steven-Johnson Syndrome


Steven-Johnson Syndrome/Toxic Epidermal necrolysis (SJS/TEN) is a life threatening exfoliative mucocutaneous disease. It often caused by a drug induce immunologic reaction such as sulfa drugs, carbamazepine, phenytoin, valproic acid, quinolones, cephalosporins, phenobarbital, allopurinol, aminopenicillins, and corticosteroids.

Signs and Symptoms:
  • History of new drug exposure within 1-3 weeks
  • Flu-like prodrome
  • Skin tenderness
  • Painful mouth lesions
  • Nikolsky's sign is positive
  • Coalescing red macules and flaccid blisters with full-thickness epidermal loss
  • Sepsis from superimposed bacterial skin infections that leads to death
Treatments:

  1. Eliminate the offending agents
  2. Analgesia and IVIG
  3. Hospitalize in the burn center to manage skin and fluid losses

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