Getting to Know Steven-Johnson Syndrome: Definition, Symptoms, and Causes All

KOMPAS.com – Topics about SJS or Stevens-Johnson Syndrome being discussed a lot on social media on Monday (28/2/2022).

Several netizens admitted that they had experienced this condition and were struggling to recover from the disease.

“I’m also allergic to drugs and just found out there’s a syndrome like this and it’s autoimmune, strong and healthy, right?“said one of the netizens.

“I also feel like I’m allergic to paracetamol, said the doctor, Steven Johnson Syndrome. When I was 17, my skin felt like it was burning, itchy and hot, it also affected my vision.,” wrote another netizen.

Then, what is SJS disease? What are the symptoms and how is it treated?

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What is SJS?

Dermatologist at RSUD Prof. Dr. Margono Soekarjo Purwokerto, dr. Ismiralda Oke Putranti Sp.KK. said that SJS is one of the emergency diseases in the field of dermatology.

Okay explained, SJS is often associated with drug allergic reactions, but can also be triggered by infections, especially viruses, bacteria, fungi, and malignancies.

“This reaction is said to be life-threatening because in addition to attacking the skin and mucous membranes, it can be accompanied by disorders of internal organs such as the kidneys and liver,” said Oke, when contacted. Kompas.com, Monday (28/2/2022).

He added that the SJS reaction in the skin is characterized by abnormalities in the eyes, skin disorders and abnormalities in the involvement of at least 2 mucous membranes (nose, mouth, genital or anus).

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Risk of death

In addition, SJS in the presence of exfoliation (epidermolysis) of more than 10 percent may progress to Toxic Epidermal Necrolysis (TEN) with a greater risk of death.

“In allergic reactions to drugs, the type of drug must be confirmed and must be stopped immediately and should no longer be consumed. Also be careful with the use of drugs of the same class because they can cause cross reactions,” he continued.

Okay revealed, drug allergies are permanent and tend to be progressive.

That is, if there is a repeated allergic reaction, the clinical symptoms that arise will be more severe than the previous reaction and the risk of death also increases.

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Treatment in RS

Considering the condition of people with SJS, Oke said, patients with allergic reactions to drugs should be taken to the hospital immediately.

This is so that patients can get immediate treatment to prevent organ damage and the expansion of skin lesions.

If this is treated on time, the patient’s recovery can be better and the treatment period is shorter.

“Handling of SSJ and NET in hospitals is generally handled by a team that is not only handled by Sp.KK. or Sp.DV. but can also involve Sp.PD or Sp.A even with doctor Sp.BP. for wound care,” said Oke. .

“In conditions of extensive exfoliation, the patient is treated like a burn patient,” he continued.

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How to know someone is allergic to drugs

Regarding drug allergies, Oke said that drug allergies are not caused, because the drugs were taken for the first time but drugs that were previously taken regularly, such as antibiotics, anti-pain, and anti-seizure drugs.

“Allergic reactions depend on reactions that take place in a person’s body,” said Oke.

However, if the reaction is in the form of redness or hives or hives, the allergic reaction usually takes place quickly, some time immediately after taking the drug.

However, the reaction of other forms takes 12-48 hours or even more which then causes a reaction.

For SJS, Oke said, there is no definite time when SJS symptoms will appear.

According to him, the average is more than 24 hours post-drug consumption.

“SJS patients who are treated early usually have good outcomes, the average recovery is less than 7 days. But if TEN requires longer treatment and the risk of complications is also greater,” said Oke.

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Symptom

Quoted from Mayo Clinic(14/4/2020), people with SJS usually experience a flu-like reaction, followed by a painful rash that spreads and blisters.

Before the rash develops, the patient may show early symptoms of Stevens-Johnson Syndrome, namely:

1. Fever
2. Sore mouth and throat
3. Fatigue
4. Burning eyes

As the condition progresses, other signs and symptoms include:

1. Unexplained widespread skin pain
2. A red or purplish rash that spreads
3. Blisters on the skin and mucous membranes of the mouth, nose, eyes and genitals
4. Formed shedding of skin fluid in a few days after the blister.

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Causes of SJS

Stevens Johnson syndrome is a rare and unpredictable disease.

Doctors may not be able to identify the exact cause, but it’s usually triggered by drugs, infection, or both.

The patient may react to the drug while he is using it or for up to two weeks after he stops using it.

Drugs that can cause sindrom Stevens-Johnson include:

1. Anti gout medications, such as allopurinol
2. Medications to treat seizures and mental illness (anticonvulsants and antipsychotics)
3. Antibacterial sulfonamides (including sulfasalazine)
4. Nevirapin (Viramune, Viramune XR)
5. Pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve)

Infections that can cause Stevens Johnson syndrome, including pneumonia and HIV.

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