Stevens Johnson syndrome

Last revised by Dr Subhan Iqbal on 10 Dec 2020

Stevens-Johnson syndrome (SJS) is an acute inflammatory skin condition. 

SJS 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%

SJS is very rare, with an incidence of 1-2 per 1,000,000 3

The diagnosis of Steven Johnson syndrome is made clinically, few clinical features include:

  • fever
  • sore throat
  • runny nose
  • myalgia
  • painful rash with mucosal surface involvement

Stevens-Johnson syndrome is thought to be triggered by preceding viral infection or more commonly medication use (e.g. NSAIDs, antibiotics, anticonvulsants). Skin and mucosal surface (e.g. gastrointestinal, genital, conjunctival) with blistering and shedding are characteristic 1-3.

Differentials of Steven Johnson syndrome include:

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