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Stevens Johnson Syndrome

There is a rare medical disorder that adults should be aware of and this is Stevens Johnson Syndrome. The condition mainly affects children and teenagers but adults can develop it too. Stevens Johnson Syndrome or SJS occurs when the body reacts to some medications taken that seriously affect the skin and mucous membranes. It may also arise as a result of an infection. The syndrome can quickly progress into life-threatening situations, so immediate action is certainly required to prevent this from happening.

Healthcare professionals are careful in diagnosing Stevens Johnson Syndrome so as not to confuse it with other skin problems. Patients are treated to assuage the symptoms and prevent the condition from becoming fatal. The syndrome may recur and is often more critical when this happens, so patients must vigilant of the drugs they are taking for infections other diseases.

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Causes of Stevens Johnson Syndrome in Adults

Most cases of SJS in adults happen as a result of an allergic reaction to certain medications. The syndrome may also be brought about by infections, health conditions and radiation therapy. There are over 200 drugs known to cause Stevens Johnson Syndrome but the most common are:

  • Antibiotics

The antibiotics used in treating bacterial infections are regarded as the most notorious medication that causes SJS. These include beta-lactam antibiotics such as cephalosporins and penicillins, as well as sulfonamide antibiotics which are used in treating MRSA and urinary tract infections.

  • Anti-convulsion medications

These medications are employed to address seizures or convulsions.

  • NSAIDs

Non-steroidal anti-inflammatory drugs have been known to cause SJS. Included in the list are naproxen, aspirin, Bextra, ibuprofen, Motrin and Advil.

  • Anti-gout medications

Allopurinol, which is used in treating gout, is another offending medication that may trigger SJS.

Studies have shown that Stevens Johnson Syndrome does not often occur in adults who are in their 20s through 60s. These people are considered to be at low risk of developing the disorder.  Rather, the condition is more common in the elderly, those with compromised immune systems, and individuals who are undergoing therapy and taking in the said suspect medications regularly. The mortality rate of SJS in adults is around 3% to 15%, which is equivalent to around 100,000 deaths every year.

Symptoms of Stevens Johnson Syndrome in Adults

Hypersensitivity to certain medications causes the skin as well as the mucous membranes to get inflamed, and this is manifested by various symptoms.

  • Flu-like symptoms

The onset of SJS starts of with flu-like symptoms which make detection quite confusing. The patient will suffer from fever, chills, nausea and vomiting. He/she will also have headache, sore throat, cough and body aches.

  • Painful skin rashes

The rashes associated to SJS have purple or red color and often start off flat.  These then spread over the skin in a matter of hours or days. The rashes appear like irregularly-shaped targets with a darker center which will eventually become raised and will combine with other skin rashes thereby forming giant blisters.

  • Blisters

Because the mucous membranes are affected as well, blistering is also evident in the nose, mouth, lips, tongue, throat and even the genitals. Swallowing foods and liquids can become difficult due to the narrowing of the esophagus.

  • Inflamed eyelids

The syndrome is also manifested by swollen eyes and eyelids, and if this is left untreated it may result in permanent blindness.

Other manifestations of the syndrome are diarrhea and some form of upper respiratory tract infection. The mild form of SJS is referred to as erythema multiforme while the most severe kind is Toxic Epidermal Necrolysis or TEN.

Complications of Stevens Johnson Syndrome

Those suspected of being afflicted with the syndrome should never delay doctor’s consultation and treatment as SJS progresses rapidly and run the risk of developing graver medical complications. Among the serious complications brought about by the syndrome include:

  • Permanent Blindness
  • Photophobia
  • Arthritis
  • Asthma
  • Permanent skin damage
  • Dry eye syndrome
  • Chronic Obstructive Pulmonary Disease
  • Chronic Fatigue Syndrome
  • Organ damage
  • Scarring of the mucous membranes and esophagus
  • Sepsis

Early intervention is critical to prevent serious and potentially deadly complications from happening. It is extremely important then, especially for individuals taking the offending medications, to become familiar with the manifestations of the syndrome.

Diagnosis and Treatment of Stevens Johnson Syndrome

Diagnosis of SJS is based on the medical history and distribution of the skin lesions. It is considered SJS if less than 10% of the skin is affected; meanwhile, a patient is said to be having TEN if the rashes and blistering cover over 30% of the entire body. Accurate diagnosis can be achieved by means of skin biopsy.

The chances of recovery significantly differ with every individual, depending on the severity of the condition. Those who have mild SJS will recuperate within a couple of months or less, while recovery takes longer for those who have more severe SJS. Long-term effects and even death are possible if SJS is ignored. Cessation of the suspect medication is the first line of treatment for Stevens Johnson Syndrome. Patients are often treated under ICU and handled by a team of healthcare professionals.

Stevens Johnson Syndrome pictures

 

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