STEVENS JOHNSON SYNDROME

Stevens Johnson syndrome orSJS is arise due to a disorder of the immune system that caused by :


1. Infections
Such as herpes simplex virus, influenza, mumps, cat-scratch fever,histoplasmosis, Epstein-Barr virus, or similar.

2. Adverse effects of drugs
Including allopurinol, diclofenac, etravirine, fluconazole,valdecoxib,sitagliptin, oseltamivir, penicillins, barbiturates, sulfonamides, phenytoin,azithromycin, modafinil, lamotrigine, nevirapine, pyrimethamine, ibuprofen,ethosuximide, carbamazepine.

3. Malignancy ( carcinomas and lymphomas )

4. Idiopathic factors.

5. Side effect of herbal supplements containing ginseng.

6. Cocaine usage.

Medications that have traditionally been known to lead to Stevens JohnsonSyndrome include :

1. Antibiotics
Including sulfonamides, penicillins.

2. Sedatives
e.g barbiturates

3. Anticonvulsants
Such as lamotrigine and phenytoin (e.g. Dilantin). Combining lamotrigine withsodium valproate increases the risk of Stevens Johnson syndrome occurring.

The symptoms of SJS :


1. Fever, sore throat, and fatigue.
SJS usually begins with these symptoms which is misdiagnosed and usuallytreated with antibiotics.

2. Ulcers and other lesions.
Ulcers and other lesions begin to appear in the mucous membranes, almost alwaysin the mouth and lips but also in the genital and anal regions. Those in themouth are usually extremely painful and reduce the patient's ability to eat ordrink.

3. Conjunctivitis of the eyes.
Occurs in about 30% of children who develop SJS.

4. A rash of round lesions.
Found on the face, trunk, arms and legs, and soles of the feet, but usually notthe scalp.
The diagnosis of SJS is usually made when the characteristic rash appears 1 to3 weeks after exposure to a known stimulus and it cannot be explained byanother diagnosis.
The treatment depends, in part, on the suspected precipitating cause. The mostcommonly prescribed medication for SJS is corticosteroids.

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