Stevens-Johnson Syndrome

(SJS)

Stee-vens Jon-son Sin-drom

Definition

Definition

Stevens-Johnson Syndrome (SJS) is a severe illness associated with fever and skin problems including rash, blisters, and ulcers. Although it can affect skin all over the body, a trademark of SJS are problems of the skin inside the mouth, nose, and eyes.

Blisters

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Causes

Causes

SJS is caused by an overreaction of the immune system to certain medications. It is not certain what causes the overreaction but it may be linked to genetic factors.

Risk Factors

Risk Factors

Medications that are most often associated with SJS include:

  • Sulfonamides
  • Aminopenicillins
  • Quinolones
  • Cephalosporins
  • Tetracyclines
  • Imidazole antifungals
  • Aromatic anticonvulsants

Other factors that may increase your chance of SJS include:

Symptoms

Symptoms

SJS symptoms progress over time. Early symptoms may include:

  • Fever
  • Sore throat
  • Cough
  • Burning eyes

After several days, the following symptoms may occur:

  • A red or purple rash that spreads
  • Swelling of the face and tongue
  • Skin pain
  • Blisters on the skin and the skin inside the mouth, nose, and eyes
  • Shedding of the skin

Diagnosis

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. This will often result in a diagnosis.

A sample of skin may be tested. This can be done with a biopsy.

Treatment

Treatment

Talk with your doctor about the best treatment plan for you. You may be referred to a specialist for treatment depending on your symptoms.

Treatment options include:

Medications

Your doctor may advise you to stop taking medications that may be causing the condition.

If not related to your symptoms, you may be given:

  • Pain medication to reduce discomfort
  • Antihistamines to reduce itching
  • Oral steroids or IV immunoglobulin (IVIG) to treat the disease
  • Lubricating or antibiotic eye drops
  • Antibiotics to treat an infection caused by bacteria

Fluid Replacement

You may be given IV fluids at the hospital to replace lost fluids.

Skin Treatments

Treatments for the skin may include:

  • Applying cool, wet compresses to blisters
  • Removing dead skin
  • Wound care

Prevention

Prevention

To help reduce your chance of getting SJS, avoid taking the medications that cause SJS to occur.

Resources:

Johns Hopkins Medicine http://www.hopkinsmedicine.org

Shriners Hospitals for Children http://www.shrinershospitalsforchildren.org

Canadian Resources:

Canadian Dermatology Association http://www.dermatology.ca

Health Canada http://www.hc-sc.gc.ca

References:

Stevens-Johnson syndrome. Johns Hopkins Medicine website. Available at:
http://www.hopkinsmedicine.org/wilmer/conditions/stevens-johnson.html
Accessed October 3, 2013.

Stevens-Johnson syndrome. Patient UK website. Available at:
http://www.patient.co.uk/doctor/stevens-johnson-syndrome
Updated November 2, 2012. Accessed October 3, 2013.

Stevens-Johnson Syndrome/toxic epidermal necrolysis. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated November 17, 2011. Accessed October 3, 2013.

Last reviewed June 2015 by Michael Woods, MD
Last Updated: 12/20/2014

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