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Stevens-Johnson syndrome

Stevens-Johnson syndrome and toxic epidermal necrolysis are two types of the same life-threatening skin reaction which are commonly caused by adverse drug reactions. Approximately 150,000 people are killed every year because of Stevens-Johnson syndrome in the United States alone. Stevens-Johnson syndrome was first discovered by two pediatricians in 1922 after they diagnosed a young child with severe oral and ocular involvement to an adverse drug reaction.

Stevens-Johnson syndrome can develop in patients of any age, but is more common in people of older age. People with AIDs are also more likely to develop Stevens-Johnson syndrome. In very rare cases, Stevens-Johnson syndrome is caused by bacterial infection, but is overwhelmingly caused by adverse drug reactions. Sulfa antibiotics, anti-convulsants (such as phenytoin and carbamazepine), non-steroidal anti-inflammatory drugs (NSAIDS), allopurinol, and other drugs are the most common culprits which cause Stevens-Johnson syndrome. The FDA recently pulled the blockbuster NSAID, Bextra, off the market due to unacceptable side effect risks, one of which is Stevens-Johnson syndrome.

Stevens-Johnson syndrome usually begins with fever, cough, body aches, and/or head aches, which can last from one day to two weeks. A red rash often develops on the trunk and face of the patient, which often spreads irregularly across the body. This Stevens-Johnson syndrome rash then worsens and develops blisters that are loose and easily rubbed off. In addition to the skin, mucous membranes lining the mouth, anus, genitals, throat, and eyes become severely blistered, swollen, and intensely irritated. As a result, eating, seeing, urinating, breathing, and digesting can be severely compromised. In some Stevens-Johnson syndrome patients, the hair and nails will also fall out.

People who develop Stevens-Johnson syndrome must be hospitalized, often in a burn clinic where infection can be prevented as best as possible. The doctor will recommend that the patient immediately discontinue use of the medication which caused Stevens-Johnson syndrome. Intravenous fluids may be given to replenish lost fluids and salts. Pain medication may also be prescribed. Some doctors favor the administration of corticosteroids to suppress the immune system, while others believe that these drugs should not be used in patients with Stevens-Johnson syndrome. Antibiotics may also be administered to prevent secondary infections.

When Stevens-Johnson syndrome is treated promptly and properly, the patient has a chance of recovery. Unlike serious burn injury cases, the skin can grow back after a serious case of Stevens-Johnson syndrome. There are, unfortunately, serious complications that can occur in patients with Stevens-Johnson syndrome. Permanent blindness, dry eye syndrome, lung damage, scarring, other serious medical conditions, and even death may all occur in patients with Stevens-Johnson syndrome.

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