STEVENS JOHNSON

SYNDROME
DERMATO
LOGY
STEVENS JOHNSON

AGENDA
SYNDROME

WHAT IS SJS?

CAUSES

RISK FACTORS

COMPLICATIONS

CLINICAL MANIFESTATIONS

DIAGNOSIS

TREATMENT
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PREVENTION
 WHAT IS SJS?
STEVENS JOHNSON
SYNDROME

• Stevens-Johnson syndrome (SJS), a rare, serious disorder of the skin and

mucous membranes.

• Usually a reaction to medications.

Flu-like symptoms painful rash spreads blisters.

• SJS is a medical emergency, requires hospitalization.

• Takes weeks-months to recover.

• Toxic epidermal necrolysis (TEN) = more severe form of SJS.

• Involves >30% of skin surface & extensive damage to mucous membranes.
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• August 18 = SJS Awareness day
STEVENS JOHNSON

CAUSES
SYNDROME

• SJS may be caused by drug allergies, infections or both.

• Drugs that can cause SJS include:

1. Anti-gout medications, such as allopurinol
2. Anticonvulsants and Antipsychotics
3. Antibacterial sulphonamides, sulfasalazine
4. HIV Meds (Nevirapine)
5. Pain relievers, such as acetaminophen, ibuprofen and naproxen sodium.

• Infections that can cause Stevens-Johnson syndrome include PNEUMONIA &

4 HIV.
 A weakened immune system

Cancer
Cancer A history of SJS

RISK FACTORS
An HIV infection Genetic
Geneticfactors
factors
An HIV infection

A family history of SJS

 COMPLICATIONS
STEVENS JOHNSON
SYNDROME

EYE LUNG PERMANENT SKIN

D E H Y D R AT I O N SEPSIS PROBLEMS I N V O LV E M E N T DAMAGE

• Areas of skin Rapidly progresses to • Rash caused by SJS Can result in Acute • When skin grows
shedding lose fluids. cause shock and organ can lead to eye Respiratory failure due back after SJS, it may
failure. inflammation, dry eye to hypoxia have bumps,
• Sores in the mouth and light sensitivity. dyspigmentation &
and throat makes fluid scars.
intake difficult • In severe cases,
resulting in causes visual • Long-term skin
dehydration. impairment and, problems can result in
rarely, blindness. hair loss.

6 • Nails may not grow

as well as they did
before.
STEVENS JOHNSON
SYNDROME

AS DISEASE PROGRESSES: Widespread skin pain, Red

or purple rash that spreads, Blisters on mucosal membranes,
Skin shedding after blister formations.

EARLY SYMPTOMS: Fever, Sore throat, Redness

and burning eyes, Fatigue

CLINICAL
MANIFESTATIONS
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 A review of medical history and physical
STEVENS JOHNSON

exam.
SYNDROME

Skin biopsy

DIAGNOSIS
Culture:
To rule out an infection, a skin, tissue or fluid culture is
taken.

Imaging.
Chest X-ray to check for pneumonia.

Blood tests.
8 These are used to confirm infection or other possible
causes.
 S TO P N O N - E S S E N T I A L M E D I C AT I O N S
Drug intake is the most imp causative factor of SJS.
Cessation of unnecessary medicines, would help cure the
disease.

S U P P O RT I V E C A R E
• Fluid Replacement and Nutrition
To prevent dehydration, fluids are
administered using Nasogastric intubation.
• Wound Care
Cool, wet compress soothes blisters.
Vaseline application helps deal with dry skin.
• Eye Care

M E D I C AT I O N S

TREATMENT
• Pain Medications
• Topical Steroids: to reduce inflammation
• Antibiotics to control infection
9 • Systemic Corticosteroids, IV Immunoglobulins,
Cyclosporin, Etanercept
STEVENS JOHNSON
SYNDROME

G E N E T I C S C R E EN I N G
B E F O R E TA K I N G C E RTA I N
DRUGS.
•The U.S. Food and Drug Administration
recommends screening people of Asian and
South Asian ancestry for a gene variation called
HLA-B*1502 before starting treatment.

AVO I D M E D I C ATI O N S T H AT
TRIGGER THE CONDITION
•If one has had SJS and if it was caused by a
medication, they should avoid that drug and

PREVENTION
others like it.
•This prevents recurrence which is more fatal
than first episode.
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 THANK YOU

ANGEL SARA THANGAMUNI

GR7 SEM8