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Stevens Johnson Syndrome

 

Stevens Johnson Syndrome (SJS) is a condition that generally develops as a result of an allergic reaction to certain medications. Young and adults alike can be afflicted by SJS. The affected individual will initially feel like he or she has contracted flu as coughs, headache and sore throat are experienced. Skin rashes will eventually develop which is then followed by blistering around the eyes, mouth and genitals. Other areas of the body may become affected as well.

Those who suffer from Stevens Johnson Syndrome should be treated the soonest possible time so as to prevent the development of complications that could lead to death. This is the reason why this syndrome shouldn’t be taken lightly and immediate medical attention, typically requiring hospitalization, should be given. SJS is treated in the same way as burns are treated in hospitals. The chances of survival significantly vary in each patient depending on the extent of damage caused by the allergic reaction and how timely the treatment was initiated.

History of Stevens Johnson Syndrome

The syndrome got its name from Dr. Albert Mason (A.M.) Stevens and Frank Chambliss (F.C.) Johnson in 1922. These doctors were perplexed by the extraordinary skin disease that afflicted 7 and 8-year old boys. They were certain that the boys’ condition were not severe hemorrhagic measles because of the existence of widespread skin lesions, severely swollen eyes and eyelids, and inflamed mucous membranes on the cheeks. These doctors initially thought the ailment was erythema multiforme or EM which is a form of skin problem that causes red papules and targeted lesions.

However, Stevens and Johnson noted some disparity between the boys’ condition and that of EM. Firstly, the boys had persistently high-grade fevers. Secondly, the rashes and lesions displayed were more severe. Thirdly, there was terminally heavy crusting. The doctors initially thought that the condition was infectious. But intensive medical studies revealed the exact cause of the problem and it was Bernard Thomas who put finality to naming it Stevens Johnson Syndrome in 1950.

Causes of Stevens Johnson Syndrome

SJS targets the skin and the mucous membranes. Mucous membranes are found all over the body as they line the cavities or passages inside the body, such as the lungs, mouth, nostrils, ears, digestive tract, anus and genitalia. They are also adjacent to the skin. SJS can be a very grave condition because it causes the skin and mucous membranes to become inflamed. The inflammation would quickly aggravate and damage not only the mucous membranes but the major organs of the body as well.

Stevens Johnson Syndrome is brought forth when the body negatively reacts to certain drugs. Under normal conditions, the body metabolizes the chemicals from the medicine the same way as the digestive system digests food. However, with SJS, a chemical component of the drug causes a wrong metabolic response by stimulating the body to excrete protein that would severely affect the cells on the outermost skin layer or epidermis. This abnormal immune response weakens the skin’s integrity, making it susceptible to foreign pathogens that would cause infections.

Any drug can trigger SJS, but the following have been commonly associated with the syndrome:

  • Antibiotics
  • Anticonvulsants
  • Anti-inflammatory drugs
  • Diuretics
  • Sedatives
  • COX-2 inhibitors

Symptoms of Stevens Johnson Syndrome

Knowing how to distinguish SJS rash or lesions from other types of skin problems is important in getting early treatment so as to prevent more severe or potentially deadly complications.

  • Rash

SJS rashes appear in red or purple hue that quickly spread to other parts of the body. Skin lesions are visible on the nose, mouth and eyes. Slow skin shedding can also be observed.

  • Flu-like symptoms

An individual with SJS will suffer from flu-like symptoms for a few days, which include headache and fever. However, SJS causes persistently high-grade fever.

  • Edema

Swelling usually develops on the tongue and face. It may also occur in the bronchus which could result in suffocation and eventual death.

It should be noted that the symptoms of Stevens Johnson Syndrome can quickly aggravate in just a few days or even in a matter of minutes. That is why suspecting individuals should be particularly weary of the symptoms of SJS, especially those who are allergic to any of the suspect medications; people with HIV; and those who are taking medications to treat infections or other health problems like herpes, typhoid, influenza and hepatitis.

Stevens Johnson Syndrome treatment

People affected by SJS need prompt medical treatment and must discontinue taking the medication or drugs that caused the adverse reaction right away and go to the hospital immediately. They are treated under the hospital’s ICU or burn unit with the close supervision of the ophthalmologist, dermatologist and even a surgeon. These doctors will determine the extent of damage caused by the allergic reaction and prevent it from aggravating further. Supportive care, such as IV fluids, parenteral feeding, analgesics and mouth rinse, will promote healing and provide relief from the uncomfortable symptoms associated with the condition. Alternative agents are sometimes used to treat secondary infections. Timely medical intervention will prevent Stevens Johnson Syndrome from causing death.

Stevens Johnson Syndrome Pictures

 

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