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General Medicine

Stevens-Johnson Syndrome

Valerie Felicia Davis Barnabas, MD, Tran K. Nguyen, MD and Nehman Moses Andry II, MD Reviewed 06/2021
 


BASICS

DESCRIPTION

  • A generalized hypersensitivity reaction, usually to a drug, in which skin and mucous membrane lesions are an early manifestation. Has also been associated with infectious agents

  • Once ...

DIAGNOSIS

HISTORY

  • A preceding illness for which medication was prescribed, typically 1 to 3 weeks before initial cutaneous manifestations

  • Sudden onset with rapidly progressive pleomorphic rash that incl...

TREATMENT

GENERAL MEASURES

  • Early diagnosis and removal of the potentially offending medications. Treat any underlying disease.

  • Meticulous skin care; similar to burn patients

  • Supportive care: fluid and el...

ONGOING CARE

  • Behavioral health management for potential long term psychological sequelae (e.g., PTSD)

  • Physical and occupational therapy to improve overall function, range of motion and quality of life

  • L...

REFERENCES

1
Struck  MF, Hilbert  P, Mockenhaupt  M, et al. Severe cutaneous adverse reactions: emergency approach to non-burn epidermolytic syndromes. Intensive Care Med.  ...

ADDITIONAL READING

Shanbhag SS, Chodosh J, Fathy C, Goverman J, Mitchell C, Saeed HN. Multidisciplinary care in Stevens-Johnson syndrome. Ther Adv Chronic Dis. 2020 Apr 28;11:2040...

SEE ALSO

Burns; Cutaneous Drug Reactions; Dermatitis Herpetiformis; Erythema Multiforme; Pemphigoid, Bullous; Pemphigus Vulgaris; Respiratory Distress Syndrome, Acute (ARDS) 

CODES

ICD10

  • L51.1 Stevens-Johnson syndrome

  • L51.3 Stevens-Johnson syndrome-toxic epidermal necrolysis overlap syndrome

SNOMED

  • 73442001 Stevens-Johnson syndrome

  • 403609001 Drug-induced Stevens-Johnson syndrom...

CLINICAL PEARLS

  • SJS and TEN are a delayed-hypersensitivity medication reaction.

  • SJS is a medical emergency. Treat patients as severe burn injuries.

  • Corticosteroid treatment is controversial. If chosen a...

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Related Images
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<bold>Figure 72-8</bold> Hemorrhagic ulcerative stomatitis in SJS. (Courtesy of Joseph Lopreiato, MD.)

 

<bold>Figure 72-8</bold> Hemorrhagic ulcerative stomatitis in SJS. (Courtesy of Joseph Lopreiato, MD.)

 
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