Stevens-Johnson syndrome is also known as toxic epidermal necrolysis, according to the Stevens Johnson Syndrome Foundation. It is a very serious skin disorder that can be potentially fatal. It affects the skin and, in some cases, the mucous membranes. SJS is most often caused by a chemical reaction to a drug. Over-the-counter as well as prescription medications may be triggers. Infections and emotional upsets have also been known to cause attacks. SJS is very painful and debilitating. Skin may become inflamed, blistered and eventually slough off.
Treatment
SJS affects the skin with many of the same symptoms and characteristics of a second- or third-degree burn. According to the Stevens Johnson Syndrome Foundation, when hospitalization is required, many times the patient is taken to a burn unit to receive treatment. Fluid loss is a major concern with SJS patients, so fluids may be reintroduced through a nasogastric tube that goes into the nose and down into the stomach. Treatment may also include placing moist compresses over the affected area. In some cases, the dead skin may need to be removed and the area covered with a bandage treated with antibacterial ointment to help fight infection. Antihistamines to relieve itching and pain relievers may be used to make the patient more comfortable. According to the Mayo Clinic, topical steroids are used to help fight inflammation.
Causes
SJS can be caused by a number of things. According to the Skin Association, one of the primary causes may be chemical reactions to drugs. Gout medications, pain relievers and nonsteroidal anti-inflammatory drugs, or NSAIDs, may cause the body to exhibit signs of this syndrome. The Mayo Clinic reports that infections that can cause SJS include the human immunodeficiency virus, or HIV; diphtheria; typhoid; and hepatitis. According to the Mayo Clinic, ultraviolet light and radiation can also trigger flare-ups of SJS. While the search for the cause of SJS symptoms is being performed, a physician may remove a patient from all unnecessary medications to ensure that none of them are actually causing the problem.
Flare-Up Signs
According to the Stevens Johnson Foundation, if a person with SJS is exposed to an allergen or substance that has caused a flare-up in the past, the individual should be watchful for signs that a flare-up may occur. SJS usually starts with flulike symptoms, including a fever, runny nose and sometimes a sore throat. The skin may begin to itch or feel tingly. Redness and inflammation may also be present. Seeking medical attention at the first sign of any of these symptoms is the best way to keep the disease from getting out of control.
Considerations
During a flare-up of SJS, staying calm and relaxed is important. Stress and anxiety can increase the severity of the symptoms as well as trigger a full blown attack. Adequate amounts of rest are also needed to ensure that the body's immune system is strong enough to fight any infection that may attempt to take hold in weakened areas of the body.
Prevention/Solution
If SJS is caused by a reaction to certain drugs, keep a list of the medications, as well as others that are similar to it, handy at all times. Medical bracelets are available that can be inscribed with Stevens-Johnson syndrome and a list of known triggers. Avoid exposure to things that can cause a flare-up. If it is unknown as to whether something may cause a flare-up, it's best to err on the side of caution and avoid the possible allergen.
