What Exactly is Stevens-Johnson Syndrome?
Stevens-Johnson Syndrome (SJS) is a rare but serious disorder affecting the skin and mucous membranes, often triggered by a reaction to medication or infection. This condition causes the skin to blister and peel, forming painful lesions. If left untreated, SJS can lead to life-threatening complications, including infection and organ damage.
You might wonder how SJS differs from other skin conditions. SJS is characterized by its sudden onset, typically beginning with flu-like symptoms before the skin reaction occurs. Often-affected sites include the mucous membrane surfaces of the mouth, eyes, and genitals, making it a medical emergency requiring immediate care.
Who is Affected by Stevens-Johnson Syndrome?
SJS is rare, affecting about 1 to 2 people per million each year. It can occur in individuals of all ages, but some people are at higher risk than others. Certain medications, such as antibiotics, anticonvulsants, and allopurinol are common triggers.
People with HIV, a weakened immune system, or a genetic predisposition are also at higher risk.
Recognizing the Signs and Symptoms of Stevens-Johnson Syndrome
The early signs of SJS can easily be mistaken for common illnesses. Flu-like symptoms such as fever, cough, and sore throat often appear first. However, within days, a painful red or purplish rash develops, spreading across the body. This rash quickly turns into blisters, causing the skin to peel and leave raw areas exposed, which can lead to infection.
Other symptoms include:
● Red, sore eyes that may be sensitive to light
● Swelling and crusting around the lips or mouth
● Difficulty swallowing due to sores in the mouth and throat
If you or a loved one experiences these symptoms, especially after starting a new medication, seek medical attention immediately.
What Causes Stevens-Johnson Syndrome?
SJS is often triggered by medications, with antibiotics, anticonvulsants, and pain relievers being the most common culprits. Infections like pneumonia or herpes can also cause SJS in some cases. Although rare, SJS may occur in individuals with genetic markers that make them more susceptible to adverse reactions.
The body’s immune system plays a role in SJS by mistakenly attacking healthy skin cells, leading to the characteristic rash and blisters.
How is Stevens-Johnson Syndrome Diagnosed?
Diagnosing SJS can be challenging because its early symptoms mimic other conditions. A specialist, such as a dermatologist, will examine the skin and mucous membranes and may perform a skin biopsy to confirm the diagnosis. It's crucial to seek care from medical professionals experienced in managing SJS, as it requires urgent treatment.
Does Stevens-Johnson Syndrome Mean I’ll Always Have Skin Reactions?
Once someone has had SJS, they are at higher risk of developing it again if exposed to the same medication or trigger. For this reason, it's essential to avoid the suspected trigger and wear medical alert bracelets to inform healthcare providers of the condition.
Living with SJS can be difficult, but recognizing the condition early and avoiding known triggers are key steps in managing it.
Reviewed by: Dr. Bruce Carleton
References
Schwartz, R. A., & McDonough, P. H. (2013). Stevens-Johnson syndrome: A review of the literature. Journal of the American Academy of Dermatology, 69(1), 32-42.
Mockenhaupt, M. (2011). Stevens-Johnson syndrome and toxic epidermal necrolysis: Clinical patterns, diagnostic considerations, etiology, and therapeutic management. Seminars in Cutaneous Medicine and Surgery, 30(4), 255-261.
Harr, T., & French, L. E. (2010). Toxic epidermal necrolysis and Stevens-Johnson syndrome.
Orphanet Journal of Rare Diseases, 5(1), 39.
High, W. A., Roujeau, J. C., & Stern, R. S. (2008). Stevens-Johnson syndrome and toxic epidermal necrolysis: Pathogenesis, clinical manifestations, and management. Dermatologic Clinics, 26(4), 579-593.
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