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Stevens Johnson Syndrome

Abstract

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Synonyms of Stevens Johnson Syndrome

  • Dermatostomatitis, Stevens Johnson Type
  • Ectodermosis Erosiva Pluriorificialis
  • Erythema Multiforme Exudativum
  • Erythema Polymorphe, Stevens Johnson Type
  • Febrile Mucocutaneous Syndrome, Stevens Johnson Type
  • Herpes Iris, Stevens-Johnson Type
  • Johnson-Stevens Disease

Disorder Subdivisions

  • No subdivisions found.

General Discussion

Until recently the relationship of Stevens-Johnson syndrome to other severe blistering disorders was a matter of some debate. Now a consensus seems to be evolving that describes SJS as a rare disorder involving lesions of the mucous membranes along with small blisters on the reddish or purplish, flat, thickened patches of skin. As a result, SJS is now distinguished as a separate disorder from erythema multiforme major (EMM). SJS is now considered to be a less severe variant of toxic epidermal necrolysis (TEN).

SJS and TEN appear to be characterized by identical clinical signs and symptoms, identical treatment approach and identical prognosis. Patients diagnosed with TEN can present with symptoms ranging from 10% skin involvement and severe threat to the patient's sight to a presentation involving 90% of the skin but only a modest threat to the patient's sight.

SJS (and TEN) is an inflammatory disorder of the skin triggered by an allergic reaction to certain drugs including antibiotics, such as some sulfonamides, tetracycline, amoxicillin, and ampicillin. In some cases, nonsteroidal anti-inflammatory medications and anticonvulsants, such as Tegretol and phenobarbital have also been implicated. Over-the-counter medications may act as triggers as well. In some cases, it is also possible that the disorder may be traced to a reaction to an infection.

One report suggests that the term SJS be limited to cases in which less than 10% of the total body surface area is involved. The authors suggest that the term TEN be limited to cases in which 30% or more of the total body surface area is involved. The term SJS/TEN Overlap is used to describe patients in whom between 10-30% of the total body surface area involved.

Stevens Johnson Syndrome Resources

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