Severe drug reactions Flashcards
What are the 3 main severe derm pathologies casued by drug reactions
Steven-Johnson Syndrome (SJS)
Toxic Epidermal Necolysis (TEN)
Drug Reaction with Esionophilla and Systemic Symptoms (DRESS)
What does DRESS stand for
Drug Reaction with Esopinphila and Systemic Symtpoms
What is the difference bwteen SJS and TEN
SJS is just a less severe TEN
SJS affects less of the skin
Systemic symptoms are present in TEN
Desquamtion occurs in TEN
What are the defintions of SJS and TEN
SJS
Mucotaneous necrosis of at least 2 mucosal sites, sepecially the mouth
TEN
Extensive skin and mucosal necoriss with systmic toxicity, which can lead to desquamation
How many mucosal sites need to be affected by mucutanoeus necorsis for SJS to be diagnosed
2
What are the drugs that cause SJS and TEN
Antibiotics (e.g. trimethoprim)
Anticonvulsants (e.g. phenytoin)
Allopurinol
NSAIDs
Can SJS and TEN have a dealyed onset
Yes
What is hte difference between SJS and TEN regarding the surface area of the skin they affect
SJS: <10%
SJS/TEN: 10-30%
TEN: >30%
What lesions does SJS and TEN present as
Rusty red lesions
Target lesions
How is the severity of SJS and TEN scored?
SCORETEN
(higher the score -> higher the mortality)
How is SJS and TEN managed
Supportive therapy
Fluids
Stop casuative drug
Intubation (if mouth ulceratoin si major)
Which area of the body (other than skin obvs) is usally affected by SJS
Mouth
Why may you need to intubate patients with SJS and TEN
As the mouth ulceration can lead to resp. failure
What are some of the long-term complications of SJS and TEN
Skin pigment changes
Scarring
Eye disease
Hair loss
Joint contractures
What type of hypersensitivity reaction occurs in DRESS
type 4
