Stevens Johnson Syndrome

Stevens Johnson Syndrome: Causes, Picture, Symptoms and Treatment

Stevens Johnson Syndrome, also known as SJS is a serious problem that needs immediate medical treatment. It is a rare problem but can affect you at any time. The problem occurs when you suffer a severe reaction to any medication you take or due to an infection. The reaction in the body can cause your skin to blister and ultimately peel off. You can observe blisters forming inside your body, even in the mucous membranes. Therefore, SJS can make it hard to eat food, swallow fluids or even urinate. But, do not worry as the problem gets solved once you seek treatment without delay. The timely medical intervention can protect your skin as well as other organs from any long-lasting damage or complications. Read ahead to get comprehensive information on the rare, yet dangerous disorder that can affect your life adversely. With medical help at the right time, you can resume your normal life without complications.

What Is Stevens Johnson Syndrome?

It is a rare and dangerous disorder that affects your mucous membranes as well as your skin adversely. The mucous membrane in your body has a soft layer of tissue. It usually lines your digestive system, which covers the area of your mouth to the anus. It also lines your reproductive organs (reproductive organs) and eyeballs. In most cases, the problem occurs due to an unpredictable adverse reaction to the specific medication you take. In other cases, infections can trigger the problem. When you suffer from flu-like symptoms along with painful rashes on your skin, then seek medical help. The purplish color rash can spread to other areas and cause blisters. Therefore, it results in the death of the affected skin. It peels away and finally heals.

Stevens Johnson Syndrome (SJS) is a rare condition affecting one in two million people around the world. You need to consider it as a medical emergency and get assistance immediately. With swift medical aid, your doctor can eliminate the underlying cause. So, it controls the symptoms you suffer and minimizes the complications associated when the skin regrows. Depending on the severity of the condition, the recovery from SJS can take from weeks to months. If the condition occurs due to the reaction by medication, then you need to stop using it permanently. Therefore, with proper care and precaution, you can manage the condition.

Symptoms Associated With Stevens Johnson Syndrome

When you suspect you have SJS, you need to look out for the following signs and symptoms:

  • Fever
  • A reddish or purple colored skin rash that can spread to other areas
  • Unexplained and widespread pain on your skin
  • Appearance of blisters on your skin as well as mucous membranes of genitals, eyes, and mouth
  • Peeling of skin within days after the blister formation
  • Blistered mucous membranes, leading to painful urination

But, before SJS shows visible signs, you see several other symptoms several days before. So, you can experience some problem that indicates the presence of SJS:

  • Rash development
  • Sore throat and mouth
  • Cough
  • Fatigue
  • Fever
  • Burning eyes

It is advised to seek medical help when you see such signs. The earlier you seek treatment, the better outcome you can expect.

Causes Of Stevens Johnson Syndrome

SJS syndrome causes dangerous side effects on your body. You can suffer from an unpredictable reaction due to the immune system reaction to a medication or suffer from an infection. It is important to seek medical attention immediately to avoid complication. But, your doctor may not find the exact problem triggering the condition. It is due to the fact that you may experience the disorder while using a medication or two weeks after discontinuing it. So, you need to inform about your medical history and the details of the medication you take to your doctor. It will help detect the actual problem conclusively. Therefore, the different medications and infections triggering the problem are:

Medication And Therapy Causes

Stevens Johnson syndrome triggers disorders in your body, mainly due to drugs and therapy. So, you need to maintain caution while using some drugs. Talk to your doctor before using drugs like:

Anti-gout medication

Allopurinol prescribed by the doctors to treat gout can trigger SJS in susceptible people. So, people with increased risk of the disorder need to talk about their concerns with the doctor.

Drugs To Treat Mental Illness And Seizures

Anticonvulsants and antipsychotic drugs offer relief to people suffering from various forms of mental diseases or epilepsy. But, it can trigger adverse reactions like SJS in some people. Some patients, for example, people who undergo radiation therapy face added risk of getting affected by SJS.

Pain Relievers

Pain and agony can affect you at any time in your life. You may take over-the-counter pain relief products or the medications offered by the doctor. But, certain pain relievers can trigger SJS. The following medications can trigger the problem:

  • Acetaminophen (example Tylenol and others)
  • Naproxen Sodium (medication like Aleve)
  • Ibuprofen (Motrin IB, Advil, and other medications)

Drugs Fighting Infection

SJS can also occur in your body due to using medication like penicillin that fights infection.

Infection Causing Stevens Johnson Syndrome

Certain infection in your body can also trigger SJS. So, the following virus or condition can trigger Stevens Johnson syndrome:

  • HIV
  • Pneumonia
  • Herpes (Herpes zoster or Herpes simplex)
  • Hepatitis A

Risk Factors Associated With Stevens Johnson Syndrome

Some people are more at risk of developing the problem compared to others. So, the risk factors that increase your chance of SJS are:

HIV Infection

People affected by HIV virus have a 100 times greater chance of developing SJS compared to others. The HIV infection can weaken the immune system, leading to the problem.

Weak Immune System

A weak immune system cannot protect you from the external factors triggering problems. Therefore, you are at risk of developing SJS. Your weak immune system gets adversely affected by autoimmune disease, organ transplant or HIV/AIDS diseases.

History Of SJS

If you have suffered from Stevens Johnson Syndrome, then you have a high risk of recurrence. It mainly occurs when you have experienced the medication-related form of SJS. When you use the drug that triggered the condition again, you can develop SJS.

Genetics

If you already have someone in your family with SJS, then you have a high risk. It is possible when your immediate family member has SJS or another related condition called toxic epidermal necrolysis. It puts you at risk of developing a rare disorder. Therefore, people with a family history of the disease need to maintain caution.

Presence Of Gene

A particular gene HLA-B 1502, can increase your risk of developing the disorder. People carrying the gene can develop SJS when they use certain drugs. The drugs for mental illness, gout, or seizures can trigger the disorder in people carrying the gene. Southeast Asian, Chinese or Indian descent families are more likely to carry the gene. Therefore, if you have the gene, then talk to your doctor before taking the specified drugs.

Complications Due To Stevens Johnson Syndrome

Stevens Johnson Syndrome can create havoc in your body. You can face severe complications due to the disease. Some may prove fatal. Therefore, you need to seek immediate help from your doctor to minimize the adverse effects. The complications associated with the issue include:

Secondary Skin Infection

Secondary Skin Infection
skin infection

Due to SJS, you are prone to get affected by cellulitis. It is a serious bacterial infection that can cause life-threatening complications. It can cause your skin to look red and swollen. You may find the area painful and has warmth when you touch.

Blood Infection

Blood Infection
Picture showing blood infection

Blood infection also referred to as sepsis can lead to the death of the affected patient. It is a common complication of SJS when the bacteria from the infection enters the bloodstream. It spreads throughout the body, leading to organ failure and shock. So, you need to prevent SJS to avoid the rapidly progressing sepsis.

Eye Problems

Stevens Johnson syndrome
eye

SJS can trigger rashes in your mucous membrane. So, it can lead to inflammation in areas like eyes. The mild case of SJS can cause dry eyes and irritation. But, in severe cases, the inflammation can lead to extensive tissue damage. So, it can cause scarring and subsequent visual impairment. In some rare cases, the problem can lead to blindness.

Lung Problems

SJS can lead to acute respiratory failure and cause severe discomfort.

Permanent Skin Damage

Once the skin starts healing, you can see abnormal bumps as well as coloring. At times, the longer you take to get treatment, it causes lasting scars. SJS causes skin problems that will lead to hair fall. You can also experience the abnormal growth of your nails and toenails. So, you need to get treatment as early as possible to minimize the risk.

Diagnosis Of Stevens Johnson Syndrome

When you suspect the problem, then you need to seek immediate medical assistance. You need to undergo the following tests and procedures to diagnose the issue precisely. So, your doctor can successfully identify Stevens Johnson Syndrome using the following tests:

Physical Assessment

In the majority of cases, your doctor can identify the problem based on your medical history. You need to discuss the medications you take with your doctor. Along with it, a physical examination can help detect the complication.

Skin Biopsy

Skin Biopsy

It is the precise method that can rule out other possible factors triggering the same symptoms and make a proper diagnosis. The doctor removes a sample of your skin. It is sent to the lab for a thorough assessment. Therefore, skin testing can detect the issue conclusively.

Culture

The skin or oral culture can also detect the problem. Your doctor can take the sample from other areas of your body. So, culture can rule out or confirm the infection.

Imaging Tests

Sometimes, children get affected by SJS. In such cases, the doctor recommends imaging tests. It is to detect the presence of pneumonia. So, a chest x-ray can provide comprehensive information that forms the basis for future actions.

Blood Tests

The blood tests can confirm the reason behind the SJS. If the infection causes the problem, then the blood tests can provide a conclusive diagnosis. It can also detect other possible causes.

Treatment Options For Stevens Johnson Syndrome

The disorder requires hospitalization. In most cases, you get treated in a burn unit or intensive care unit. The treatment involves the following steps:

Stopping Unwanted Medications Immediately

The most important step your doctor takes to combat the problem is to stop any unwanted medication. You may get the disorder due to the reaction to medications. Since it is difficult to pinpoint the exact drug triggering the problem, your doctor recommends avoiding all nonessential medications. So, you can see improvement in your condition by discontinuing the unwanted drugs.

Supportive Care During Hospital Stay

You need supportive care during your stay in hospital. Your doctor suggests fluid replacement and nutrition. It is to replenish the fluid loss due to SJS. It is a significant part of the treatment to keep up your strength. The nasogastric tubes provide you the necessary fluids. It is placed through your nose and proceeded into your stomach.

Wound Care

The wound formed due to Stevens Johnson syndrome requirement care to manage it. So, placing cool and wet compress will soothe the blisters. It will offer you relief while your blisters heal. The health care team offers relief by removing the dead skin and placing a medicated dressing or petroleum jelly over it. Therefore, wound care will make your healing faster.

Eye Care

SJS can affect your eyesight. So, during your hospital stay, ophthalmologists can check your condition. So, it can avoid any complication associated with your eyes.

Medications

Doctors prescribe medication to relieve the agonizing symptom associated with SJS. So, you are offered the following drug to alleviate the discomfort:

  • Pain medication, to diminish the agony associated with Stevens Johnson Syndrome
  • Topical steroids, to reduce the inflammation of mucous membranes and eyes
  • Antibiotics offered as per necessity can control the infection

The systemic medication offered to patients suffering from the problem can reduce the severity of symptoms. Depending on the individual case, your doctor offers a treatment option to deal with the issue. The medications are offered after carefully analyzing the patient’s other health issues. Therefore, you may receive the prescription for the following medications:

  • Immune globulin
  • Oral steroids
  • Immune-related medications

You need to get immediate treatment to eliminate the reason that causes the skin reaction. Once you stop the reaction, your body starts to heal. So, new skin begins to grow in the affected area after a few days. In some cases, people affected by SJS take several months to recover completely.

Remedies To Deal With Stevens Johnson Syndrome

You can also adopt some steps in your life to prevent the problem from affecting your life. So, you can implement the following pointers:

Know The Problem Triggering The Reaction

You have to understand the exact cause that triggers the reaction. Determine if the problem occurs due to taking medication. Learn the name of the medication that causes the complication along with the closely related medications.

Inform Your Doctors

You need to talk to your doctors about your symptoms. Always inform the health care provider about your prior history of Stevens Johnson Syndrome. If you have awareness about the specific medication triggering the problem, then inform your doctor.

Wear Medical Bracelet

Wear Medical Bracelet

Wearing a medical bracelet can offer significant information about your specific condition. The medical information inscribed in the necklace or bracelet can shed light on the medication triggering the serious condition. So, it will help in case of emergencies. Always wear it to prevent any unwanted complications.

Preventing Steven Johnson Syndrome

Is it possible to prevent SJS? Well, yes! By following some crucial steps, you can keep the problem at bay. It helps you avoid the problem completely. So, try to implement the following pointers:

Genetic Testing

You need to consider genetic testing before consuming a certain type of drugs. It will help you realize the risk you face due to your genetics. If you belong to Indian, Chinese or Southeast Asian descent, then consider genetic testing. Talk to your doctor before taking medicines used to treat problems like bipolar disorders, epilepsy or other conditions. The HLA-B 1502 genes can enhance your risk of Stevens Johnson syndrome when you take drugs like Tegretol or Carbatrol (carbamazepine). Therefore, genetic testing can reveal if you can face side effects when you take the drugs.

Avoid Recurrences

If you have already faced the condition, then you need to avoid the medication triggering it in the future. Contacting your doctor immediately after the first occurrence of the problem can help you detect the medication causing it. So, you can avoid it as well the other similar to it. It is the key to prevent future recurrences of the problem. In most cases, the next episode of the problem has severe effects compared to the first. Therefore, avoid the fatal complication by stopping the drugs causing it completely. Ask your family members to avoid the drug. It is due to the fact that the drug can have a genetic risk factor.

Conclusion

With proper treatment at the right time, you can overcome Stevens Johnson syndrome within two to four weeks. Some people may take a longer duration to recover from the syndrome. But, with proper medical care, you can prevent severe complications. When you fail to get treatment, the issue can lead to severe problems. In most cases, the three after the syndrome starts can trigger severe issues. Therefore, get medical help to prevent risk. You have better chances of overcoming the problem when you have a healthy and young body.

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