Stevens-Johnson syndrome (SJS) is an acute inflammatory skin condition, which is one of the drug-induced severe cutaneous adverse reactions (SCARs).
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Terminology
Stevens Johnson syndrome is on a spectrum of disease with toxic epidermal necrolysis syndrome (TENS) at the more severe end. Terminology depends on how much of the body surface area is involved 1,2:
SJS: <10%
SJS-TENS overlap: 10-30%
TENS: >30%
Epidemiology
Stevens-Johnson syndrome is very rare, with an incidence of 1-2 per 1,000,000 3.
Clinical presentation
The diagnosis of Stevens-Johnson syndrome is made clinically, few clinical features include:
fever
sore throat
runny nose
myalgia
painful rash with mucosal surface involvement
Pathology
Stevens-Johnson syndrome is thought to be triggered by preceding viral infection or more commonly medication use (e.g. NSAIDs, antibiotics, antiseizure medications). Skin and mucosal surface (e.g. gastrointestinal, genital, conjunctival) with blistering and shedding are characteristic 1-3.
Differential diagnosis
Differentials of Stevens-Johnson syndrome include:
drug hypersensitivity reactions
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