The predicted mortality rates in this cohort are shown in the table. The role of systemic corticosteroids cortisone remains controversial. However concerns have been raised that they may increase the risk of infection, impair wound healing and other complications, and they have not been proven to have any benefit.
They are not effective later in the course of the illness. Case reports and small patient series have reported benefit from active adjuvant treatments delivered during the first 24—48 hours of illness. There are contraindications to treatment such as renal impairment. Cross-reactions can occur between:. Repithelialisation of denuded areas takes several weeks and is accompanied by peeling of the less severely affected skin. Survivors of the acute phase have increased on-going mortality especially if aged or sick.
See smartphone apps to check your skin. Books about skin diseases Books about the skin Dermatology Made Easy book. DermNet NZ does not provide an online consultation service.
If you have any concerns with your skin or its treatment, see a dermatologist for advice. Lyell syndrome, Erythema multiforme exudativum, Ectodermosis erosiva pluriorificialis. Reaction to external agent. Approach to the acute, generalized, blistering patient.
Semin Cutan Med Surg ; — Cotliar J. Approach to the patient with a suspected drug eruption. Semin Cutan Med Surg ; Phenotypic diversity in delayed drug hypersensitivity: An immunologic explanation. Mount Sinai Journal of Medicine ; — Mockenhaupt M. Once the cause of Stevens-Johnson syndrome has been identified and successfully treated in the case of an infection , or stopped in the case of medication , the skin reaction will stop.
New skin may start to grow after a few days. But the length of time it takes to recover from Stevens-Johnson syndrome will depend on how severe it is, and it can sometimes take many weeks or months to fully recover.
It's common to feel tired and lack energy for several weeks after being discharged. If the cause was an adverse reaction to medication, you'll need to avoid that medication and possibly other similar medications for the rest of your life. As Stevens-Johnson syndrome severely affects the skin and mucous membranes, it can cause a number of complications. Problems with the sexual organs, such as vaginal stenosis narrowing of the vagina caused by a build-up of scar tissue and scarring of the penis, is also a possible complication of Stevens-Johnson syndrome.
If Stevens-Johnson syndrome has been caused by an adverse reaction to a medication, you'll need to avoid taking this medication and other similar medications. Other family members may also want to avoid using the medication in case there's a genetic susceptibility within your family. If you have had Stevens-Johnson syndrome in the past and your doctor thinks you're at risk of getting it again in the future, you'll be warned to look out for the symptoms.
If you're of Chinese, southeast Asian or Indian descent, genetic testing may be recommended before taking medications known to have an associated risk of causing Stevens-Johnson syndrome, such as carbamazepine and allopurinol.
Testing will help determine whether you carry the genes HLA B and HLA B that have been associated with the syndrome when taking these medications. Page last reviewed: 04 October Next review due: 04 October Treatment depends on the extent of eye involvement and may involve any of several strategies either alone or in combination, including: [4] [6] Saline rinses to clean the eyes and eyelids.
Lubrication multiple times per day with preservative-free eye drops or ointments including for those with no apparent eye involvement. Eye medicines with topical corticosteroids and broad-spectrum antibiotics.
Amniotic membrane transplantation AMT to try to prevent vision loss and complications involving the mucous membranes. Some people need multiple procedures. The amniotic membrane is the innermost layer of the placenta, and can been used as a graft or dressing to aid in repairing the surface of the eyes and promote healing. Beyond supportive care, various therapies have been tried by doctors, including systemic corticosteroids, intravenous immune globulin IVIG , cyclosporine , plasmapheresis , and anti-tumor necrosis factor TNF monoclonal antibodies.
However, with the exception of thalidomide which was found to be harmful , none have been adequately studied in randomized trials. There is, however, increasing evidence that cyclosporine may slow the progression of the condition.
Prognosis Prognosis. The long-term outlook and chance of recovery varies from person to person. Regrowth of the affected skin typically occurs in two to three weeks, but recovery can take weeks to months, depending on the severity of symptoms. Feelings of overwhelming tiredness may persist for months. Depression may also develop. For some, complications may develop within weeks to months of an acute episode, and there may be long-term complications involving the skin and affected mucous membranes, which can severely impact quality of life.
However recurrent episodes due to different medications or infections have also been reported. The most common causes of death include sepsis , acute respiratory distress syndrome , and multiple organ failure. Find a Specialist Find a Specialist. Healthcare Resources To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. You can also learn more about genetic consultations from MedlinePlus Genetics.
Research Research. Clinical Research Resources ClinicalTrials. Click on the link to go to ClinicalTrials. Please note: Studies listed on the ClinicalTrials. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study. Learn More Learn More. Where to Start MayoClinic. This website is maintained by the National Library of Medicine. The Merck Manuals Online Medical Library provides information on this condition for patients and caregivers.
In-Depth Information Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free. Stevens-Johnson syndrome Toxic Epidermal Necrolysis TEN The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers.
This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
Click on the link to view a sample search on this topic. Have a question? References References. High WA. Stevens-Johnson syndrome and toxic epidermal necrolysis: Pathogenesis, clinical manifestations, and diagnosis. Stevens-Johnson syndrome. Stevens-Johnson syndrome and toxic epidermal necrolysis: Management, prognosis, and long-term sequelae.
Kang MH. Hanyang Med Rev. Foster CS. Stevens-Johnson Syndrome. Medscape Reference. Harr T, French LE. Orphanet Journal of Rare Diseases. Br J Dermatol. June ; 6 Do you know of a review article?
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