Stevens-Johnson syndrome is a rare, serious disorder in which your skin and mucous membranes react severely to a medication or infection.Often, Stevens-Johnson syndrome begins with flu-like symptoms, followed by a painful red or purplish rash that spreads and blisters, eventually causing the top layer of your skin to die and shed.Stevens-Johnson syndrome presents a medical emergency that usually requires hospitalization.Treatment focuses on eliminating the underlying cause, controlling symptoms and minimizing complications.
Recovery after Stevens-Johnson syndrome can take weeks to months, depending on the severity of your condition.If your doctor determines that your case of Stevens-Johnson syndrome was caused by medication, you'll need to permanently avoid the medication and all others related to it.Stevens-Johnson syndrome requires immediate medical attention.Seek emergency medical care if you experience any of the following signs or symptoms: The exact cause of Stevens-Johnson syndrome can't always be identified.Usually, the condition is an allergic reaction in response to medication, infection or illness.
Medication causes
Medications are most often the cause of Stevens-Johnson syndrome.Drugs commonly a*sociated with Stevens-Johnson syndrome include: SJS constitutes a dermatological emergency.All medications should be discontinued, particularly those known to cause SJS reactions.Patients with documented mycoplasma infections can be treated with oral macrolide or oral doxycycline.
Initially, treatment is similar to that for patients with thermal burns, and continued care can only be supportive (e.g.intravenous fluids and nasogastric or parenteral feeding) and symptomatic (e.g., analgesic mouth rinse for mouth ulcer).Dermatologists and surgeons tend to disagree about whether the skin should be debrided.
Beyond this kind of supportive care, there is no accepted treatment for SJS.Treatment with corticosteroids is controversial.Early retrospective studies suggested that corticosteroids increased hospital stays and complication rates.There are no randomized trials of corticosteroids for SJS, and it can be managed successfully without them.
Other agents have been used, including cyclophosphamide and cyclosporine, but none has exhibited much therapeutic success.Intravenous immunoglobulin (IVIG) treatment has shown some promise in reducing the length of the reaction and improving symptoms.Other common supportive measures include the use of topical pain anesthetics and antiseptics, maintaining a warm environment, and intravenous analgesics.An ophthalmologist should be consulted immediately, as SJS frequently causes the formation of scar tissue inside the eyelids, leading to corneal vascularization, impaired vision and a host of other ocular problems.SJS proper (with less than 10% of body surface area involved) has a mortality rate of around 5%.The risk for death can be estimated using the SCORTEN scale, which takes a number of prognostic indicators into account.Other outcomes include organ damage/failure, cornea scratching and blindness.
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