Stevens-Johnson Syndrome

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• Drugs (sulfonamides, penicillin, sedatives), viruses or other infection (e.g. orf, herpes simplex), neoplasia or other systemic disease induce a systemic illness with fever, arthralgia, myalgia ± pneumonitis and conjunctivitis

• Vesicles develop in mucosa of mouth, GU tract ± conjunctivae

• Skin develops typical target lesions of erythema multiforme, often on the palms

• May blister in centre

• Signs may also include polyarthritis and diarrhoea


Treatment:

• Usually self-limiting -> supportive care will usually suffice (e.g. calamine lotion for skin)

• Steroids (systemic + eye-drops) have been used but results vary -> dermatologist & opthalmologist

• Ciclosporin has also been used with some success

• IV immunoglobulin is not helpful


Prognosis:

• Mortality = 5%

• May be severe for 1st 10/7 before resolving over 30/7

• Damage to eyes may persist => at worst blindness can occur