 Stevens-Johnson syndrome - A potentially deadly skin disease
Stevens-Johnson syndrome Quote: Definition
Quote: Stevens-Johnson syndrome — also called erythema multiforme major — is a rare, serious disorder of the skin and mucous membranes. Often, Stevens-Johnson syndrome begins with several days of flu-like symptoms, followed by inflammation of your mucous membranes and a painful red or purplish rash that spreads and blisters, eventually causing the top layer of your skin to die and shed.
Although the cause isn't always clear, Stevens-Johnson syndrome usually is a specific type of allergic reaction in response to medication or infection. An emergency medical condition, Stevens-Johnson syndrome requires hospitalization. Treatment focuses on eliminating the underlying cause, if possible, controlling symptoms and minimizing complications. Recovery after Stevens-Johnson syndrome can take several weeks to several months, depending on the severity of your condition.
If your doctor determines that your case of Stevens-Johnson syndrome was caused by medication, be sure to avoid that medication and all others related to it that may cause a similar reaction, because recurrences of Stevens-Johnson syndrome can be fatal. | | Quote: Stevens-Johnson Syndrome is a potentially deadly skin disease that usually results from a drug reaction. Another form of the disease is called Toxic Epidermal Necrolysis, and again this usually results from a drug-related reaction. Drugs that have been linked to Stevens-Johnson Syndrome include NSAIDS (non-steroid anti-inflammatory drugs), Allopurinol, Phenytoin, Carbamazepine, barbiturates, anticonvulsants, and sulfa antibiotics. In some cases, the condition is caused by a bacterial infection, and in many cases there is no known cause for the onset of Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis.
These skin diseases can cause massive pain, suffering and anxiety. People that have taken or are taking medications such as the ones mentioned above are urged to familiarise themselves with the symptoms of SJS (Stevens-Johnson Syndrome) and Toxic Epidermal Necrolysis (TEN). This will enable you to seek immediate medical attention should the need arise, and early initiation of treatment can make a big difference to the seriousness of the disease as this can stop any secondary infections. | Quote: Causes
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•Drugs and malignancies are most often implicated as the etiology in adults and elderly persons.
•Pediatric cases are related more often to infections than to malignancy or a reaction to a drug.
•A medication such as sulfa, phenytoin, or penicillin had previously been prescribed to more than two thirds of all patients with SJS. The anticonvulsant oxcarbazepine (Trileptal) has also been implicated. Hallgren et al reported ciprofloxacin-induced SJS in young patients in Sweden and commented on several others.2 Metry et al reported SJS in 2 HIV patients treated with nevirapine and mentioned one other in the literature.3 Metry et al speculated that the problem may extend to other non-nucleoside reverse transcriptase inhibitors. Indinavir has been mentioned. In 2007, the FDA issued a warning that SJS/TEN had occurred in patients taking modafinil (Provigil).
•More than half of the patients with SJS report a recent upper respiratory tract infection.
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•The 4 etiologic categories are (1) infectious, (2) drug-induced, (3) malignancy-related, and (4) idiopathic.
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---◦Viral diseases that have been reported include herpes simplex virus (HSV), AIDS, coxsackie viral infections, influenza, hepatitis, mumps, mycoplasmal infection, lymphogranuloma venereum (LGV), rickettsial infections, and variola.
---◦Bacterial etiologies include group A beta streptococci, diphtheria, Brucellosis, mycobacteria, Mycoplasma pneumoniae, tularemia, and typhoid.
---◦Coccidioidomycosis, dermatophytosis, and histoplasmosis are the fungal possibilities.
---◦Malaria and trichomoniasis have been reported as protozoal causes.
---◦In children, Epstein-Barr virus and enteroviruses have been identified.
---◦Drug etiologies include penicillins and sulfa antibiotics. Anticonvulsants including phenytoin, carbamazepine, valproic acid, lamotrigine, and barbiturates have been implicated. Mockenhapupt et al stressed that most anticonvulsant-induced SJS occurs in the first 60 days of use.4 In late 2002, the US Food and Drug Administration (FDA) and the manufacturer Pharmacia noted that SJS had been reported in patients taking the cyclooxygenase-2 (COX-2) inhibitor valdecoxib. In 2007, the US FDA reported SJS/TEN in patients taking modafinil (Provigil).
---◦Various carcinomas and lymphomas have been associated.
---◦SJS is idiopathic in 25-50% of cases.
| | | | Quote: | extensive sloughing of epidermis from Stevens | Quote:
Sheetlike desquamation on the foot in a patient with toxic epidermal necrolysis | Quote:
Hemorrhagic crusting of the mucous membranes in toxic epidermal necrolysis |
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Last edited by trimurtulu; 02-25-2009 at 12:54 AM.
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02-25-2009, 12:48 AM
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