What is it?

Stevens-Johnson syndrome is a rare, serious disorder of the skin and mucous membranes. It's usually a reaction to medication that starts with flu-like symptoms, followed by a painful rash that spreads and blisters. Then the top layer of affected skin dies, sheds and begins to heal after several days. Stevens-Johnson syndrome is a medical emergency that usually requires hospitalization. Treatment focuses on removing the cause, caring for wounds, controlling pain and minimizing complications as skin regrows. It can take weeks to months to recover.

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Signs & symptoms

One to three days before a rash develops, early signs of Stevens-Johnson syndrome may appear, including:
- Fever
- A sore mouth and throat
- Fatigue
- Burning eyes
As the condition develops, other signs and symptoms include:
- Unexplained widespread skin pain
- A red or purplish rash that spreads
- Blisters on the skin and the mucous membranes of the mouth, nose, eyes and genitals
- Shedding of skin within days after blisters form

Diagnosis

Tests and procedures used to diagnose Stevens-Johnson syndrome include:
- A review of medical history and a physical exam: Especially a review of current and recently stopped medications, and a physical exam.
- Skin biopsy: To confirm the diagnosis, and rule out other possible causes.
- Culture: Skin or oral culture or culture from other areas may be taken to confirm or rule out infection.
- Imaging: Depending on symptoms, it might be recommended to perform imaging such as a chest X-ray to check for pneumonia.
- Blood tests: These are used to confirm infection or other possible causes.

Treatment

Treating Stevens-Johnson syndrome requires hospitalization, possibly in an intensive care unit or a burn unit.

The first and most important step in treating Stevens-Johnson syndrome is to stop taking any medications that may be causing it. Because it's difficult to determine exactly which drug may be causing the problem, it is recommended to stop taking all nonessential medications.

Supportive care includes:
- Fluid replacement and nutrition. Because skin loss can result in significant loss of fluid from the body, replacing fluids is an important part of treatment.
- Wound care. Cool, wet compresses might help soothe blisters while they heal. It might be recommended to remove dead skin and put petroleum jelly (Vaseline) or a medicated dressing over affected areas.
- Eye care

Medications used in the treatment of Stevens-Johnson syndrome include:
- Pain medication to reduce discomfort.
- Medication to reduce inflammation of the eyes and mucous membranes (topical steroids).
- Antibiotics to control infection, when needed.

If the underlying cause of Stevens-Johnson syndrome can be eliminated and the skin reaction stopped, new skin may begin to grow within several days. In severe cases, full recovery may take several months.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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