Symptoms & Treatment of Stevens Johnson Syndrome (SJS)
Stevens-Johnson Syndrome (SJS) is a severe medical condition affecting the skin and mucous membranes throughout the body. SJS often develops from an allergic reaction to drugs. These drugs can include brand names like Bextra (Bextra and SJS), Daypro, Motrin, Ibuprofen and Advil. The disease can also be caused by contraction of an illness or infection of some kind, and in some cases, it can result from unknown causes.
An immune-complex-mediated hypersensitivity (allergic) condition, SJS sufferers experience inflammation of the skin and mucous membranes. Stevens Johnson Syndrome typically affects people over the age of 40, though cases have been reported involving sufferers as young as three months old. Men are more likely to contract SJS than women at a ratio of two to one. A potentially life-threatening condition, SJS yields a fatal result in approximately 3% to 15% of all victims.
Stevens-Johnson Syndrome is one of three conditions of a similar nature, having varying severity. Erythema multiforme is a lesser form of the condition (SJS is occasionally referred to as erythema multiforme major), while toxic epidermal necrolysis (TEN) is the most serious form of the condition.
Erythema multiforme: A type of skin condition that can be characterized by the development of symmetrically raised red skin areas without displaying whole-body symptoms, erythema multiforme is associated with a number of infections, drug sensitivities, allergies and pregnancy. This condition occurs frequently in children and young adults.
Toxic epidermal necrolysis: A type of life-threatening skin condition that can be characterized by the blistering and peeling of the top layer of skin. Associated with immune complex hypersensitivity, TEN is the most serious of the three related skin conditions.
Symptoms of Stevens Johnson Syndrome
The severity of the physical symptoms associated with SJS vary from one sufferer to the next dependent on the severity of the disease and the extent of the person's hypersensitivity. In the earliest stage of the condition, SJS symptoms can include headache, general discomfort and chronic cough with secretions of the lungs, bronchi or trachea (purulent sputum). As the condition progresses and spreads throughout the body, rashes and lesions begin to develop on the surface of the skin as well as on the mucous membranes of the lungs, digestive system, genitals, eyes and mouth.
Simple dermatological lesions (macules) that can only be seen and not felt develop into conically raised lesions (papules) that can be both seen and felt. Papule development can be accompanied by large, fluid-filled blisters (bullae) or redness of the skin (erythema). Rashes and lesion development can be localized or it can spread to other areas of the body. Advanced lesions can bulge and rupture, baring large sections of flesh (denuded skin) and leaving it susceptible to infection. Severe cases of SJS can lead to blindness resulting from corneal blistering and lesion development in the mouth and digestive system can make eating and drinking difficult to the point of impossible.
Symptoms that are associated with Stevens-Johnson Syndrome lead sufferers to a consultation with a doctor. A diagnostic examination can yield a variety of SJS related signs, including:
- Hypotension
- Fever
- Conjunctivitis
- Seizures
- Corneal ulcerations
- Nose bleeds (epistaxis)
- Increased heart rate (tachycardia)
Treating Stevens Johnson Syndrome
Treatment of SJS revolves around a prompt diagnosis of the condition. A high percentage of SJS sufferers contract the disease as a result of an allergic reaction to a drug of some kind. The first step in SJS treatment is therefore targeting the cause of the disease and isolating it. After establishing the source of the problem, intravenous fluid (macromolecules and saline solutions) replacement is used to help offer preliminary relief for the lesions/blisters of the skin and mucous membranes. Sufferers must then be admitted to an intensive care center where their risk of infection is greatly reduced.
Specific care depends on the exact nature of a case of SJS, in addition to the degree to which it has spread throughout the body. The use of topical antiseptics to dress denuded skin is an essentially component in staving off infection. Corticosteroids are occasional used to reduce tissue inflammation, though their use is viewed as somewhat controversial subject they can lead to a number of additional problems such as increased risk of developing infection (corticosteroids suppress immune system response to prevent inflammation).
Treatment for Vision Problems Associated with SJS
Currently, there is no effective treatment modality for stopping the spread of Stevens-Johnson Syndrome. In some cases of Steven-Johnson Syndrome, the eye corneas are scarred by the spread of the rash. Although typically not used for the treatment of Stevens-Johnson syndrome, laser eye surgery can be used to treat corneal scarring. The eye surgeon uses an excimer laser to gently ablate the scarred corneal tissue from the outer layers of the cornea to restore clear vision. Types of laser eye surgery include LASIK, PRK and epi LASIK. LASIK eye surgery cost is about the same and PRK cost or Epi LASIK cost. Laser eye surgery is not to be confused with cataract surgery, which is used to treat a condition created by the build-up of protein deposits in the eye lens (called cataracts). Contrast sensitivity testing can be used to assess the amount of vision loss caused by corneal scarring or a cataract.
If you suspect that your SJS symptoms were caused by an adverse drug reaction, contact a skilled personal injury attorney to find out if compensation might be available. Many of the best SJS injury lawyers can help clients in a variety of situations. For example, many SJS lawyers can recommend other legal professionals practicing as car accidents attorneys, DUI specialists, cerebral palsy litigation experts and divorce lawyers.