Stevens-Johnson syndrome is an allergic reaction characterized by rashes and blisters on the skin, lining of the eyeballs, oral cavity, anus, and genitals. This disease can cause serious complications if not treated immediately.
Stevens-Johnson syndrome occurs as a result of the body's hypersensitivity reaction to drugs or infections. This disease is an emergency condition that must be treated and hospitalized.
Stevens-Johnson syndrome is different from erythema multiforme . The rash in Stevens-Johnson syndrome is more extensive, and the patient's symptoms are more severe.
Causes of Stevens-Johnson Syndrome
In adults, Stevens-Johnson syndrome can be caused by the side effects of the following medications:
- Gout medications, such as allopurinol
- Pain relievers, such as meloxicam, naproxen, or piroxicam
- Antibiotics, such as penicillin or sulfonamides
- The antiviral drug nevirapine
- Anticonvulsants , such as phenytoin , carbamazepine and lamotrigine
Whereas in children, this syndrome is more often triggered by a viral infection . However, in rare cases, this condition can also be caused by a bacterial infection.
Some viral infections that can cause Stevens-Johnson syndrome are:
- Pneumonia
- HIV
- Hepatitis A
- mumps _ _ _
- Flu
- Bornholm disease
- Herpes
- Glandular fever
Risk factors for Stevens-Johnson Syndrome
There are several factors that can increase a person's risk of Stevens-Johnson syndrome, namely:
- Having a genetic abnormality that can trigger the side effects of certain drugs
- Have suffered from Stevens-Johnson syndrome or have a family member who has suffered from this condition
- Suffering from cancer, especially blood cancer
- Having a weak immune system, for example due to having just undergone an organ transplant, side effects of chemotherapy, suffering from HIV/AIDS, or autoimmune disease
Symptoms of Stevens-Johnson Syndrome
The initial symptoms that appear in Stevens-Johnson syndrome resemble flu symptoms, namely:
- Fever up to 38 o C or more
- The body feels tired
- Sore mouth and throat
- Eyes feel hot
- Cough
- Joint pain
- Headache
As the condition progresses, advanced symptoms will appear in the form of:
- Blisters on the skin, especially in the nose, eyes, mouth, and genitals
- A widespread reddish or purplish rash
- The skin peels off a few days after the blisters form
- A burning sensation that spreads across the skin
When should you go to the doctor?
Immediately seek medical help from a doctor if you experience symptoms of Stevens-Johnson syndrome, especially if you have risk factors or triggers, such as the consumption of certain drugs. Symptoms can appear while taking the drug, or 2 weeks after stopping using the drug.
Diagnosis of Stevens-Johnson Syndrome
Doctors can suspect that a patient has Stevens-Johnson syndrome if there are a number of symptoms that have been explained before, especially if the patient has a history of diseases that can trigger this condition. A physical examination will then be performed to confirm the symptoms experienced.
To strengthen the diagnosis and rule out possible symptoms caused by other conditions, the doctor will carry out further examinations, such as:
- Blood test , to detect infection
- Biopsy, taking a sample of skin tissue or mucosal lining, to be cultured or examined under a microscope
- Chest X-ray photo, when the doctor suspects the patient's condition is caused by pneumonia
Treatment of Stevens-Johnson Syndrome
Patients with Stevens-Johnson Syndrome should be treated intensively in hospital. If the patient is taking medication, the first step taken by the doctor is to ask the patient to stop taking the medication.
After that, the doctor will give medicines to ease the symptoms, such as:
- Painkillers to ease the pain
- Antibiotics, in patients with bacterial infections
- Corticosteroid - type anti-inflammatory drugs , which are applied or taken to reduce inflammation in the affected area
To help the healing process, the doctor will also carry out some of the following efforts:
- Provide a substitute for nutrition and body fluids through a feeding tube , to replace the fluids and nutrients lost due to peeling of the skin
- Compressing the wound with a wet cloth to ease the pain of the blister during the healing process
- Examine the eyes and give eye drops if needed
Stevens-Johnson syndrome can be cured if the cause can be overcome. After the symptoms on the skin subside, generally new skin will grow in a few days. However, in severe cases, the healing process may take up to several months.
Complications of Stevens-Johnson Syndrome
If not treated right away, Stevens-Johnson syndrome can trigger a number of the following complications:
- Lung damage that can trigger respiratory failure
- Permanent skin damage , such as discoloration, bumps, or scars on the skin that can cause hair loss, skin contraction and contraction (contracture), and abnormal nail growth
- Inflammation in the eye that can trigger damage to the eye tissue, even blindness
- Inflammation of internal organs, such as pneumonia, myocarditis , nephritis, hepatitis, and esophageal stricture
- Dehydration
- Blood stream infection ( sepsis )
- Bacterial infection of the skin ( cellulitis )
- Toxic epidermal necrolysis (NET), which is marked by an expansion of the rash, if Stevens-Johnson syndrome worsens
Prevention of Stevens-Johnson Syndrome
To prevent Stevens-Johnson syndrome, avoid the consumption of drugs that can trigger this condition, especially if you or your family have a history of this disease. Therefore, ask your doctor about any type of medicine that you need to avoid or be aware of.
If necessary, perform an allergy test before consuming these medicines. If you do an examination with a new doctor, always tell the doctor if you are or have suffered from this condition, along with the cause or trigger.