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  • Kerangka Konsep Ispa

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    Tri Difanny Isma
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    Stevens Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) can cause severe skin reactions and mucosal lesions, and are life-threatening conditions. The mortality rate is 5-10% for SJS and 23-30% for TEN, and is higher in elderly patients. Proper management requires identifying and removing the offending agent, replacing fluid and electrolyte losses, treating wounds similarly to burns, managing pain, and employing a multidisciplinary care approach.

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    Kerangaka penyakit dm

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    Kerangka konsep ispa

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    Stevens Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) can cause severe skin reactions and mucosal lesions, and are life-threatening conditions. The mortality rate is 5-10% for SJS and 23-30% for TEN, and is higher in elderly patients. Proper management requires identifying and removing the offending agent, replacing fluid and electrolyte losses, treating wounds similarly to burns, managing pain, and employing a multidisciplinary care approach.

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    9 views12 pages

    Kerangka Konsep Ispa

    Uploaded by

    Tri Difanny Isma
    Stevens Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) can cause severe skin reactions and mucosal lesions, and are life-threatening conditions. The mortality rate is 5-10% for SJS and 23-30% for TEN, and is higher in elderly patients. Proper management requires identifying and removing the offending agent, replacing fluid and electrolyte losses, treating wounds similarly to burns, managing pain, and employing a multidisciplinary care approach.

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    of 12

    STEVENS JOHNSON SYNDROME (SJS) - TOXIC

    EPIDERMAL NECROLYSIS

    Ners Hizkianta Sembiring


    BACKGROUND

     Morbidity And Mortality  Morbidity And Mortality


     The leading causes of death in TEN are  Variables associated with a poor prognosis
    sepsis from Staphylococcus aureus or  increased age, extent of disease, extent of
    Pseudomonas aeruginosa and disease at time of transfer to a burn center,
    fluid/electrolyte abnormalities azotemia, multiple medication use,
     The mortality rate thrombocytopenia, and neutropenia
     5%-10% for SJS  Ophthalmologic sequelae
     23%-30% for TEN  keratitis and corneal ulcerations, cornel
     Higher in elderly scarring
     blindness occur in 40%-50% of patients
    DEFINISI
    SJS - Lesions: Small blisters on dusky
    purpuric macules or atypical targets
     Mucosal involvement common
     Prodrome of fever and malaise
    common

    Toxic Epidermal Necrolysis:


    Confluent erythema is common.
    Outer layer of epidermis separates
    easily from basal layer with lateral
    pressure.
    Large sheet of necrotic epidermis
    often present.
    >30% BSA involved.
    EPIDEMIOLOGY

     2-7/million people/year
     SJS: age 25-47, TEN: age 46-63
     Women: >60%
     Poor prognosis:
     Intestinal/Pulmonary
    involvement
     Greater extent of detachment
     Older age
     Mortality:
     SJS: 5%
     TEN: 30%
    CLINICAL PRESENTATION

     SJS
     atypical target lesions or purpuric
    macules on the trunk
     oropharyngeal lesions causing an
    erosive stomatitis
     purulent conjunctivitis can lead to
    ocular erosions and blindness
     SJS is a selflimited disease
    TREATMENT

     supportive
     removal of the offending agent
     replacement of fluid losses
     similar to burn victims
     analgesics
     all drugs started within the past month
    should be discontinued
     avoid Silvadene (silver sulfadiazine)
     woundcare
    Diagnosis : BIOPSI &
    KULTUR JARINGAN

    Removal of Cause

    Spesific treatment :
    Fluit/electrolyte & Nutrition,
    infection Wound care Pain Control

    Complication

    Multi disiplin ilmu

    MANAGING PATIENTS WITH SJS IN NURSING


    WOUND CARE
    Moist Wound Depent on Wound
    Healing Wound dressing
    Procedure Exudate
    Farmacologies : pain killer
    Non Farmacologies : hypno
    nursing therapy

    PAIN MANAGEMENT
    PERAWAT
    PERAWAT

    FISIOTERAPI
    FISIOTERAPI DOKTER
    DOKTER

    PASIEN
    ANALIS
    ANALIS
    APOTEKER
    APOTEKER

    LAINNYA
    LAINNYA AHLI
    AHLI GIZI
    GIZI

    MULTIDISCIPLINE INTERVENTION ; PCC


    SUMMARY

     Perawat harus memahami


    dengan baik teknik
    perawatannya
     Terutama terkait dengan luka
    disekujur tubuh
     Penanganan nyeri yg dialami
    non farmakologis/farmakologis

    Actually, we can
    TERIMA KASIH

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