Stevens-Johnson syndrome is a life-threatening skin disease that usually appears as an allergic reaction to certain medications such as sulfa antibiotics, barbiturates, penicillins, anti-convulsant medications and the gout medication allopurinol. In rare cases, Stevens-Johnson syndrome may occur in response to an already existing infection such as herpes, HIV, diphtheria, typhoid or hepatitis. While later symptoms of the disease often necessitate seeking medical attention, some may mistake early symptoms for a minor allergic reaction or flu.
First Symptoms
The initial symptoms of Stevens-Johnson syndrome often mimic a bad cold or the flu. People may first experience a fever, sore throat, cough or the sensation of burning in their eyes, according to the Mayo Clinic. Some experience general body aches and a flat red rash that breaks out on the face and trunk of the body. When people experience these first symptoms they often do not realize that this is the beginning of a potentially life-threatening situation and do not contact their physician until the disease progresses further.
Progression
The Merck Online Medical Library explains that as the disease progresses, the areas of rash begin to enlarge, with blisters often forming in the center. The skin of the blisters is often loose and rubs off easily. Eventually the top layer of skin will die and slough off. Blisters will also form on the mucous membranes lining the mouth, throat, genitals, anus and eyes. The damage will make eating difficult and closing the mouth painful. The eyes will often become painful and fill with pus, causing them to seal shut and potentially causing scarring to the eyes. If the rash and skin loss progresses past 10 percent of the surface area of the body it is no longer considered Stevens-Johnson syndrome it has become toxic epidermal necrolysis.
Time Frame
The active stage of rash and skin loss often lasts between one to 14 days, according to Merck Manuals Online Medical Library. The early symptoms of the disease can occur anywhere from one day to two weeks after beginning a medication, according to the Skin Association, an association dedicated to helping people who have Stevens-Johnson syndrome. Once the person develops the rash, it can take just hours for the rash to spread throughout the body.
Treatment
Physicians will often place those with Stevens-Johnson syndrome and toxic epidermal necrolysis in the burn unit of the hospital where they will be cared for by staff that is used to dealing with patients with compromised skin integrity. This can often prevent infection. If the patient is still on the medication causing the skin reaction, the physician will stop the drug immediately. Skin loss often results in severe loss of fluids from the body. The Mayo Clinic explains that physicians will often prescribe fluid replacements for patients. Feedings are often given through a tube introduced through the nose and placed down to the stomach known as a nasogastric tube because swallowing is often too painful. Physicians will also prescribe cool compresses to help soothe blisters as well as the removal of dead skin to avoid infection.
Prognosis
Stevens-Johnson syndrome and toxic epidermal necrolysis have a high death rate, according to the National Institutes of Health. Recovery often depends on early treatment and whether the patient develops an infection.
