scholarly journals Multidisciplinary care in Stevens-Johnson syndrome

2020 ◽  
Vol 11 ◽  
pp. 204062231989446 ◽  
Author(s):  
Swapna S. Shanbhag ◽  
James Chodosh ◽  
Cherie Fathy ◽  
Jeremy Goverman ◽  
Caroline Mitchell ◽  
...  
Keyword(s):  
Supportive Care ◽  
Toxic Epidermal Necrolysis ◽  
Oral Mucosa ◽  
Acute Phase ◽  
Multidisciplinary Care ◽  
Stevens Johnson Syndrome ◽  
Chronic Complications ◽  
Optimal Care ◽  
Johnson Syndrome ◽  
Organ Systems

Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are potentially fatal mucocutaneous diseases that can involve many organ systems. Manifestations of SJS/TEN outside of the skin, eyes, and oral mucosa are not well defined or well recognized, and, therefore, are often not addressed clinically. As supportive care improves and mortality from SJS/TEN decreases, chronic complications in affected organ systems are becoming more prevalent. Recognition of the manifestations of SJS/TEN in the acute phase is critical to optimal care. In this review, we review the organ systems that may be involved in SJS/TEN, provide an overview of their management, and propose a list of items that should be communicated to the patient and family upon discharge. The organ systems discussed include the pulmonary, gastrointestinal/hepatic, oral, otorhinolaryngologic, gynecologic, genitourinary, and renal systems. In addition, the significant psychosocial, nutritional, and pain consequences and management of SJS/TEN are discussed.

scholarly journals Clinical Features and Treatment Outcomes among Children with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A 20-Year Study in a Tertiary Referral Hospital

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Susheera Chatproedprai ◽  
Vanvara Wutticharoenwong ◽  
Therdpong Tempark ◽  
Siriwan Wananukul
Keyword(s):  
Supportive Care ◽  
Toxic Epidermal Necrolysis ◽  
Treatment Outcomes ◽  
Clinical Features ◽  
Systemic Therapy ◽  
Stevens Johnson Syndrome ◽  
Tertiary Referral Hospital ◽  
Systemic Corticosteroids ◽  
Johnson Syndrome ◽  
Morbilliform Rash

Aim. To determine the probable causative factors, clinical features, and treatment outcomes of Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS-TEN overlap in children.Methods. A 20-year database review of all children diagnosed with SJS/TEN/SJS-TEN overlap at the King Chulalongkorn Memorial Hospital, Thailand.Results. 36 patients (M : F, 16 : 20) with the mean age of9.2±4.0years were identified. There were 20 cases of SJS, 4 cases of SJS-TEN overlap, and 12 cases of TEN. Drugs were the leading cause for the diseases (72.3%); antiepileptics were the most common culprits (36.1%). Cutaneous morphology at presentation was morbilliform rash (83.3%), blister (38.9%), targetoid lesions (25.0%), and purpuric macules (2.8%). Oral mucosa (97.2%) and eye (83.3%) were the 2 most common mucosal involvements. Majority of the cases (77.8%) were treated with systemic corticosteroids, intravenous immunoglobulin, or both. Treatment outcomes between those who received systemic therapy and those who received only supportive care were comparable. Skin and eye were the principal sites of short-term and long-term complications.Conclusions. SJS/TEN are not common but are serious diseases which lead to significant morbidities in children. Early withdrawal of suspicious causes and meticulous supportive care are very important. This study found that the systemic therapy was not superior to supportive care because the treatment outcomes for both groups were comparable.

scholarly journals Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

2020 ◽  
Vol 82 (6) ◽  
pp. 1553-1567 ◽  
Author(s):  
Lucia Seminario-Vidal ◽  
Daniela Kroshinsky ◽  
Stephen J. Malachowski ◽  
James Sun ◽  
Alina Markova ◽  
...  
Keyword(s):  
Supportive Care ◽  
Toxic Epidermal Necrolysis ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Care Guidelines

scholarly journals Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

2021 ◽  
Vol 8 ◽  
Author(s):  
Swapna S. Shanbhag ◽  
Virender S. Sangwan ◽  
Aastha Singh ◽  
Pragnya R. Donthineni ◽  
Sayan Basu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Toxic Epidermal Necrolysis ◽  
Acute Phase ◽  
Chronic Phase ◽  
Stevens Johnson Syndrome ◽  
Clinical Aspects ◽  
Ocular Involvement ◽  
Ocular Complications ◽  
Johnson Syndrome

Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a spectrum of rare, severe immunological blistering skin reactions which are triggered by medication intake or infections. The acute phase is characterized by necrolysis of the skin and desquamation of mucosa, primarily oral and ocular, with significant mortality rates. The chronic phase is characterized by multi-organ sequelae with increased rates of morbidity and reduced quality of life for patients who have survived the acute phase. Since the primary goal in the acute phase is saving the life of the patient, ocular involvement is often missed and a significant proportion of patients present to an ophthalmologist with the chronic ocular sequelae. In India, chronic ocular sequelae and low vision are observed in two-thirds of patients who present in the chronic phase of SJS/TEN. In the chronic phase of ocular involvement, there are definite windows of opportunity which if targeted with specific interventions such as scleral lenses and mucous membrane grafts can help reduce the incidence of corneal blindness and improve the quality of life for patients with SJS/TEN. Over the last decade, several studies from India have advanced the understanding of the natural course of ocular involvement in SJS/TEN and the outcomes of timely interventions in the chronic phase of the disease. We present an overview of the epidemiology of ocular complications of SJS/TEN in India, the specific challenges faced in the management of ocular complications in the acute stage and recent advances in management of the chronic ocular complications of the disease.

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