Steven Johnson Syndrome – Pictures, Symptoms, Causes, Treatment

Steven-Johnson syndrome is an uncommon and severe condition characterized by an adverse reaction of mucous membranes and the skin to an infection or to a particular drug. In most cases, it starts with the symptom of flu-like fever, which is followed by the appearance of a red or purple colored painful rash. Afterwards, the rash spreads and forms blisters. As a result, the uppermost skin layer decays and falls off.

A person affected by Stevens-Johnson syndrome has to be hospitalized and undergo emergency treatments. The target of treatment is to manage the symptoms, remove the cause of the symptoms, and curtail further complications.

Depending on the severity of the disorder, the recovery may take a few weeks or months. If it is found that a drug was the cause for the reaction, then its intake should be stopped immediately.

Symptoms of Steven-Johnson syndrome

The signs and symptoms of Stevens-Johnson syndrome are as follows:

Formation of hives
Swelling of the face and tongue
The soft mucous membranes and skin may develop blisters, particularly areas such as the nose, mouth, and eyes.
The affected skin may be painful
The outer skin may decay and fall off
Reddish or purplish rash may spread quickly within hours or days.

People affected by Stevens-Johnson syndrome may have the following symptoms prior to formation of the rashes:

Flu-like fever
Soreness of throat
Cough
Burning sensation in the eyes

The following are some of the complications experienced due to Stevens-Johnson syndrome:

Stevens-Johnson syndrome can result in ocular problems such as eye inflammation.Irritation and dry eyes are the signs of mild Stevens-Johnson syndrome. Acute and severe cases of Stevens-Johnson syndrome may cause tissue damage which may even result in blindness.
Severe infection of skin and the acute manifestation of secondary skin infections such as meningitis, cellulitis etc. are dangerous and life threatening. Meningitis is a dangerous condition which results in infection of fluid occurring around the spinal cord and brain, as well as infection of the membranes.
Stevens-Johnson syndrome can cause damage to the internal organs which may lead to lesion formation and result in inflammation of heart, lungs, kidneys, and liver.
A dangerous situation can also arise wherein bacteria enter the body via the infected wounds and causelife-threatening sepsis. It is possible for the bacteria to travel all across the body via the blood stream, thereby resulting in organ failures, coma or shock, and even fatalities.
Stevens-Johnson syndrome can cause multiple and lasting harm to the skin such as decay of skin;occurrence of pigmentation marks and irregular bumps; scarring of the skin; abnormal growth of the toe and fingernails; and hair fall followed by absent or decreased hair growth. Proper treatment of Stevens-Johnson syndrome can control the extent of damage and allow complete recovery.

Causes of Steven-Johnson syndrome

It is not possible to identify the causes of Stevens-Johnson syndromein all cases. However in most cases,the abnormalities are caused by an allergic reaction to medications, illness, or to an infection. Medications are the main cause for Stevens-Johnson syndrome. The following are some of themedicines known to cause the syndrome:

Various types of penicillin that are administered to control infections
NSAIDs or non-steroidal anti-inflammatory drugs which are consumed to reduce pain
Anticonvulsants which are given to control seizure disorders.
Anti-gout drugssuch as allopurinol

The following are some of the infections that can cause Stevens-Johnson syndrome:

HIV
Typhoid
Herpes simplex or Herpes zoster
Influenza
Hepatitis
Diphtheria
In some cases, radiation therapy or exposure to ultraviolet rays

Certain factors that increase the risk of getting Stevens-Johnson syndrome are shown below:

Presence of conditions that reduce the immune system strength, such as HIV,lupus, and other disorders.
Persons with a gene called HLA-B12 are at greater risk to developing Stevens-Johnson syndrome.

Treatment of Steven-Johnson syndrome

Steven-Johnson syndrome is always considered as a serious condition and is treated as a case of emergency in the ICUor a burn unit.

As it is very difficult to locate the exact drug that is causing the irritation, as a first step, intake of all medications is stopped. Then, the following supportive care is given to a patient affected by Stevens-Johnson syndrome while he/she is in hospital:

The dead skin is removed and the wounds are dressed with the help of topical anesthetic.
When the wounds are getting healed, wet and cool compresses are used to soothe them
Enough inflow of fluids into the body is ensured via medical and manual methods, so as to compensate for the loss of fluids experience by a patient of Stevens-Johnson syndrome
The doctor may treatitching with antihistamines; control the inflammation by providing topical steroids; and manage infection with antibiotics and pain killers.
An eye doctor may be consulted to prevent any damage to the eyes.
In cases involving extensive damage of the skin, doctors may opt for skin grafting to repair and rejuvenate it.