DermKnowledgeBASE: Stevens johnson Syndrome

Stevens johnson Syndrome

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The text is the summary of recent articles on Stevens johnson Syndrome at 75 thresold from National Library of Medicine (NLM). This information is subject to NCBI's Disclaimer and Copyright notice.

A 45-year-old male patient by chance on re-exposure to Ofloxacin developed severe cutaneous adverse drug reaction (SCADR), diagnosed with toxic Epidermal necrolysis [1]. It consists of Stevens-Johnson syndrome/toxic Epidermal necrolysis (SJS/TEN), drug reaction with eosinophilia and Systemic symptoms (DRESS), acute Generalized exanthematous pustulosis (AGEP), and Generalized Bullous fixed drug eruptions (GBFDE) [2]. Indications for fitting included limbal stem cell Deficiency, post-photorefractive keratectomy (PRK) decentred ablation, pellucid marginal degeneration, Stevens-Johnson syndrome, keratoconus, dry Eye, neurotrophic keratitis, exposure keratitis from facial nerve paralysis, and post-radial keratotomy (RK) symptoms [3]. Her condition stabilized and her skin involvement did not progress after the addition of Etanercept [4]. The role of nonprescription medications alone, or in combination with Antibiotics in triggering SJS/TEN, is largely unknown [5].

This study summarized data collected from patient surveys about nonprescription and antibiotic use prior to a SJS/TEN diagnosis [6]. This survey captured valuable information about nonprescription and antibiotic use in SJS/TEN patients [7]. Evidence is growing that epigenetic variation, particularly DNA methylation, is associated with autoimmune diseases [8]. Consequently, the interpretation of DNA methylation results should be performed with great caution due to the heterogeneous nature of the sample [9]. Differential diagnosis includes toxic epidermal necrolysis, staphylococcal scalded skin syndrome, epidermolysis bullosa, and Stevens-Johnson syndrome [10].

Inclusion criteria were studies investigating associations between HLA genotypes and OXC-cADRs that reported sufficient data for calculating the frequency of HLA genotype carriers among cases and controls [11].  RESULTS: The initial searches identified 91 articles, of which 6 studies met the selection criteria [12]. Forty patients (29 female) had experienced different hypersensitivity reactions due to AEDs: Maculopapular exanthema (26 patients), Stevens-Johnson syndrome (6 patients), drug rash with eosinophilia and systemic symptoms (7 patients), toxic Epidermal necrolysis (1 patient) [13]. Toxic Epidermal necrolysis, Stevens-Johnson syndrome, and Multiform Exudative erythema are part of the same disease spectrum [14]. The pathophysiology of toxic Epidermal necrolysis is similar in many respects to that of superficial skin burns [15].

It is generally accepted that patients with toxic epidermal necrolysis are better treated in burn units, which are experienced in the management of patients with extensive skin loss [16]. La necrolisis epidérmica tóxica, el síndrome de Steven Johnson y el eritema exudativo multiforme forman parte del mismo espectro de enfermedad [17]. La fisiopatología de la necrolisis epidérmica tóxica es semejante en muchos aspectos a la de las quemaduras dérmicas superficiales [18]. Se acepta en General que los pacientes con necrolisis epidérmica tóxica son tratados mejor en unidades de grandes quemados, donde existe experiencia en el manejo de enfermos con pérdida cutánea extensa [19]. El tratamiento es de soporte, eliminación y cobertura con derivados biosintéticos de la piel de las zonas afectadas, tratamiento de la afectación Mucosa, y tratamiento inmunosupresor específico [20].

De los tratamientos ensayados sólo se usa actualmente en la mayor parte de los centros la inmunoglobulina G y la ciclosporina A, aun cuando no existe evidencia sólida para recomendar ningún tratamiento específico [21]. The Temporal relationship between the development of SJS and the vaccination suggests that the rabies vaccination probably was the causal agent [22]. toxic Epidermal necrolysis and Stevens-Johnson syndrome/toxic Epidermal necrolysis overlap syndrome were associated with longer stay, greater mortality, and higher hospital charges than those with Stevens-Johnson syndrome [23]. Sulphonamide antibiotics are commonly accepted as one of the primary causes of SJS/TEN [24]. We further quantified absolute risks of SJS/TEN within separate cohorts of antibiotic users and assessed causality in each exposed case using an adapted version of the algorithm of drug causality in Epidermal necrolysis (ALDEN) [25].

We retrospectively analyzed 10 cases that consisted of 6 males and 4 females, which comprised 7 adenocarcinomas, 2 squamous cell carcinomas and one Pleomorphic Carcinoma [26]. One of these AEs was severe (Stevens-Johnson syndrome grade 4) but could be treated by steroid pulse therapy, steroid ointment and instillation [27].

References: 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ,

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I have varied research interests ranging from eHealth, Health Information Exchange, Clinical Trials and Research, Contact Dermatitis, Bioinformatics, and Cosmetic Dermatology. I have work experience in Canada as an eHealth analyst, and in Dubai and India as a Specialist Dermatologist.


Bell Raj Eapen
Hamilton, ON