The Mayo Clinic reports that Stevens-Johnson syndrome is a rare but serious medical condition in which the skin and mucus membranes react severely to a medication or infection. A severe form of the disease is known as toxic epidermal necrolysis. These conditions are medical emergencies and require immediate attention.
Causes
Stevens-Johnson syndrome is most often caused by an interaction with a drug. The Skin Association reports that many drugs have been linked to Stevens-Johnson syndrome, including nonsteroidal anti-inflammatories, allopurinol, sulfa antibiotics, carbamazapine and anti-convulsants. Stevens-Johnson syndrome can also be caused by a bacterial infection. In rare cases, no cause for the syndrome can be found.
Symptoms
The Skin Association warns that Stevens-Johnson syndrome can start with nonspecific symptoms, including fever, cough, headaches and body aches. Within a few days, the diseases characteristic red or purple rash will appear on the face and trunk and continue to spread outward. The rash will often begin to blister around the eyes, mouth and vaginal area. With toxic epidermal necrolysis, sheets of skin will easily peel away and the hair and nails might also be easily removed.
Diagnosis
A diagnosis is often made upon examination of the patient. The affects of Stevens-Johnson syndrome and toxic epidermal necrolysis are so distinct that often no further testing is needed. A doctor can choose to take a skin sample for confirmation.
Complications
Because of the complete breakdown of the skin, numerous complications can occur. Skin is the body's protection from bacteria. With the patients barrier compromised, the first concern is infection. If the skin becomes infected, it can cause meningitis (an infection of the membrane and fluid surrounding the spinal cord and brain) which can lead to sepsis (a systemic infection). Sepsis can occur when bacteria enters the bloodstream. In addition to a systemic infection, other parts of the body can be damaged as well. According to the Mayo Clinic, inflammation around the eyes can lead to extensive tissue damage and permanent scarring. In extreme cases, it can cause blindness. Lesions might form on the patients internal organs and lead to inflammation. As the skin grows back, noticeable discoloration or bumps might appear. The patient's hair might fall out frequently and nails might not grow back normally.
Treatment
If Stevens-Johnson syndrome is caused by a medication reaction, the drug will be stopped immediately. While no specific protocol is in place for the treatment of the disease, it will include fluid replacement. Patients with Stevens-Johnson syndrome lose fluids because the skin is compromised. Patients are often given food, fluids and medications through a tube introduced into the nostril down to the stomach instead of intravenously. That prevents further destruction of the skin and helps prevent introducing bacteria into the bloodstream. Because of the devastating effects on the skin, patients are often treated in the burn unit, where nurses will attempt to preserve the intact skin. Other treatments can include pain medication, antibiotics, topical steroids to reduce inflammation and antihistamines to relieve itching.
