Stevens–Johnson Syndrome

What Is Stevens–Johnson Syndrome?

Stevens Johnson Syndrome is a significantly rare hypersensitivity dysfunction. In this disease, the skin and the mucous membranes get affected and is caused as a result of an adverse reaction to certain medications or due to an underlying infectious process. In the initial stages of this disease, the patient may experience flu like symptoms which is then followed by purple colored rash which is at times painful which then spreads and converts into blisters. Stevens Johnson Syndrome is a potentially serious medical condition and requires immediate medical attention usually in a hospital setting where the underlying cause of the disease is eliminated along with control of symptoms and curtailing complications that may arise from this disease. It may take months for the affected person to improve from Stevens Johnson Syndrome depending on how severe the disease process is.

What Is Stevens–Johnson Syndrome?

What Are The Causes Of Stevens–Johnson Syndrome?

As stated above, Stevens Johnson Syndrome is most often caused by some adverse reaction to certain class of medications as well as an underlying infection. Below mentioned are some common medications and infectious conditions that can cause Stevens Johnson Syndrome.

  • Allopurinol
  • Carbamazepine
  • Sulfadiazine
  • Sulfasalazine.

Some antiviral medications that can cause Stevens Johnson Syndrome are Nevirapine and Abacavir

Some antiseizure medications can also cause Stevens Johnson Syndrome. These medications are:

  • Phenobarbital
  • Valproic acid
  • Phenytoin.

Some of the other class of medications that can cause Steven-Johnson Syndrome are:

  • Antifungal agents like Imidazole
  • NSAIDs like meloxicam
  • Salicylate
  • Sertraline.

Some infections which can cause Steven-Johnson Syndrome are:

  • Viral Infections: Viral infections like herpes simplex virus, enterovirus, Epstein-Barr virus, enteroviruses, influenza, mumps, etc. can cause Steven-Johnson Syndrome in children
  • Bacterial Infections: Bacterial infections like like Group-A beta-hemolytic streptococcus, diphtheria, mycobacteria, and typhoid can cause Steven-Johnson Syndrome in children.
  • Fungal Infections: Fungal infections like coccidioidomycosis and histoplasmosis can cause Steven-Johnson Syndrome in children.

It has also been noted in some cases that Steven-Johnson Syndrome in children has also been caused due to vaccination from measles or hepatitis B.

What Are The Symptoms Of Stevens–Johnson Syndrome?

Some of the symptoms of Stevens Johnson Syndrome are:

  • Swelling of the face
  • Swelling of the tongue
  • Hives
  • Purple colored rash which later forms into blisters in the face, mouth, nose or eyes
  • Shedding of skin
  • Fever
  • Sore throat
  • Severe fatigue
  • Cough
  • Burning of the eyes.

How Is Stevens–Johnson Syndrome Diagnosed?

In order to diagnose Stevens Johnson Syndrome, the treating physician will conduct the following:

Physical Examination: Physicians usually are able to diagnose Stevens Johnson Syndrome based on the history and physical examination of the individual Doctors by identifying the classic signs and symptoms of the disease.

Skin Test: Apart from a physical examination, a skin test will also be conducted to confirm the diagnosis.

What Are Treatments For Stevens–Johnson Syndrome?

Treatment of Stevens Johnson Syndrome requires inpatient setting usually in an intensive care unit. The first aim of the treatment is to stop all medications that may be causing this disease. Then, fluid replacement and adequate nutrition is given so that fluids that are lost because of the disease may be replenished. These fluids and nutrition is usually given through an NG tube. Cool compresses are kept over the blisters for keeping them calm as they heal. Apart from this medications may also be given to cut down pain and inflammation like the following:

  • Pain medication to cut down pain and discomfort
  • Medication which controls itching
  • Antibiotics for control of underlying infection that may be causing the disease
  • Topical steroids to reduce skin inflammation.

Severe cases of Stevens Johnson Syndrome may take several months to improve where as mild cases of Stevens Johnson Syndrome may be eliminated much earlier.

What Are The Complications Of Stevens-Johnson Syndrome?

  • Some of the gastrointestinal and respiratory manifestations may advance to necrosis.
  • There may be secondary infection and scarring of the skin
  • There may be mucosal scarring which may lead to functional loss of the involved organ
  • If there is involvement of the esophagus then it may lead to esophageal strictures
  • There may be mucosal shedding in the tracheobronchial tree which may cause respiratory arrest
  • Ophthalmological complications include corneal ulcerations and uveitis. In around 10% of cases, the disease may lead to complete blindness
  • In some cases, vaginal stenosis has been observed.
  • In rare cases, renal failure has also been observed as a complication of Stevens Johnson Syndrome.

Awareness and Care For Stevens-Johnson Syndrome

Awareness about what was the cause of the adverse reaction and to stay away from that medication or a derivative of it.

One should make sure that the treating physician is appropriately informed about a history of Stevens Johnson Syndrome, if it is present, and if it was caused by a medication then provide the name of the medication.

Can Stevens-Johnson Syndrome Be Treated Naturally?

Yes, there are certain ways to treat Stevens Johnson Syndrome naturally using certain herbs and making dietary changes can help with the symptoms of Stevens Johnson Syndrome.

To start with, the body needs to be completely detoxified from the offending medication or infection causing the disease in the first place. This goes a long way in improving symptoms.

Once it is done, then the patient should be given diet formed of raw foods. It is advisable to avoid refined and processed foods from the diet. Emphasis should be given on fruits, vegetables, and lots of water. It should be mentioned here that the water given to affected person should be ionic or alkaline if possible as this is the best form of water for this disease.

There are also some herbs which can be given for amelioration of the symptoms caused by Stevens Johnson Syndrome. These herbs can be added in the food that is given to the child:

  • Oregon Grape
  • Echinacea Root
  • Goldenseal Root
  • Burdock Root
  • Ilex
  • Mullein Leaf
  • Eucalyptus
  • Boneset
  • Coltsfoot
  • Lobelia.

Steven Johnson Syndrome And Disability Benefits

Steven Johnson Syndrome is a debilitating as well as life threatening medical condition. It can cause permanent impairment like loss of vision, blurry vision, skin marks, scars, and psychological impact etc. People suffering from SJS suffer from blisters that are very painful and tend to leave sores which are prone to infection. There can be blisters or infections on hands, fingers, legs, and neck making it difficult to carry on activities of daily living as well as perform work related activities.

If this condition has led to vision loss or permanent blindness then the chances of qualifying for disability benefits is good.

Recovery period can be anywhere from few weeks to years depending on how severe the medical condition is, and if that is preventing you from working, then you could be a candidate for Social Security Disability Benefits. You need to contact disability attorney or an advocate who have prior experience in winning disability benefits for Steven Johnson Syndrome and help you get the money that you are entitled to.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: August 4, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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