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Steven Johnson Syndrome and Burns (Part II)

Steven Johnson Syndrome is a systemic allergic reaction that has high morbidty and can lead to death in severe cases. It is charactarized by the appearance of rash on the skin and the mucous membrane. This syndrome can affect the eye, respiratory and nasal tracts, vagina and the urethra.

What are the complications of Steven Johnson Syndrome:

Steven Johnson Syndrome may affect any organ in the body. Some are serious and may even lead to death. Complications may include:

Skin complications: a target shaped rash appearing on the skin and mucous membrane that is red to purple in color that may lead to the formation of scars, other complications may include skin peeling, abnormal nail growth and scarring hair fall.

Eye complications: dryness of the eyes, corneal holes and ulcers, Conjuctival damage, damage to the eye tissues, scarring or complete visual loss.

Shock and sepsis: sepsis is a medical emergency in which bacteria enters the bloodstream and spreads through the blood to dofferent body organs that may lead to shock and organ failure.

Damage to internal organs: inflammation caused by the disease may cause damage to the internal organs such as the kidney, liver, heart and lungs. It may lead to respiratory failure,renal failure, scarring and stenosis in the vagina and the penis.

Diagnosis of Steven Johnson Syndrome:

The diagnosis of the disease is done by taking the patient’s history, performing a physical exam looking for the signs and symptoms of the disease and/or performing laboratory test in the form of a skin biopsy.

Treatment:

Steven Johnson Syndrome is considered as a dermatological emergency and may require hospital admission as it may lead to death in severe cases. The cause of the disease should be identified if possible. If the cause is an allergic reaction to a drug, the drug should be discontinued. a precipitating agent should also be identified and removed.
The initial treatment is simillar to the treatment of patient with thermal burns. The treatment given to the patinet is both symptomatic to treat symptoms such as pain medications and mouth wash and supporive treatment to support such as feeding and intravenous fluids. Among the medicine used are Dexamethasone, cyclosporine, intravenous immunoglobin and others.

What is the prognosis:

Steven Johnson Syndrome is a rare medical condition with a low mortality rate (5%). Proper and early treatment help cure the disease and prevents complications. Risks include corneal ulceration and loss of vision or damage to other organs, that’s why it’s important for the patient to consult with an ophthalmologist if there is an eye complaint.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.