Steven-Johnson syndrome

Diagnosis

Diagnosing SJS entails a thorough inquiry into the individual’s health background, encompassing current and recently ceased medications, along with a comprehensive physical assessment. The examination focuses on inspecting the afflicted skin and mucus membranes. Factors such as the intensity of pain, rapidity of skin involvement, and the scope of affected skin are carefully evaluated during the diagnostic process.

Tests that may be required include:

• Blood tests: Presence of infection or other potential causes may be identified in this test.
• X-ray: This can help examine for conditions such as pneumonia that may be causing the symptoms.
• Culture: This involves collecting a sample of skin, tissue, or fluid for laboratory testing (culture) in order to rule out an infection.
• Skin biopsy: Skin sample is extracted for lab analysis to rule out potential causes or confirm a diagnosis.

Treatment

Management of Stevens-Johnson syndrome encompasses multiple strategies, including discontinuation of the causative medication, administering supportive care, and adhering to prescribed medications. Hospitalization, which may include intensive care or burn unit support, could be warranted. Collaborative efforts involving specialist teams from dermatology and ophthalmology may be required, particularly if ocular complications arise.

Treatments for SJS:

• Avoiding triggering medications: Healthcare providers might advise stopping all nonessential medications to prevent further harm, especially in people on multiple drugs. This is the initial and crucial treatment for Stevens-Johnson syndrome.
• Medications: Antibiotics may be used to control infections, while pain relief medications are provided for comfort. Other medications include:
  • Topical steroids: These can lessen inflammation in the mucous membranes and eyes.
  • Oral and systemic drugs: Such as IV immunoglobulin and corticosteroids. Research indicates that etanercept and cyclosporine are effective medications for this illness.
• Supportive care:
  • Replenishing electrolytes and nutrition: Administering high-calorie nutrition, possibly via tube-feeding, and replenishing electrolytes through intravenous fluids can be part of the treatment. Replacing lost fluids is an important element of treatment since skin loss can cause significant fluid loss from the body.
  • Wound care: Applying non-adhesive dressings on the affected skin can aid the healing. This include using medicinal dressing or petroleum jelly to treat the afflicted areas after carefully removing any dead skin. Cool, moist compresses may be used to ease blisters while they heal.
  • Eye care: You may also require care from an ophthalmologist.

If the reason for SJS is removed and skin reaction halted, a new skin might start growing within a few days. Severe cases of SJS could take several months for complete recovery.