Steven Johnson's Syndrome

Question 1

What is Steven Johnson’s syndrome?

Answer 1

-potentially fatal acute skin disorder

Question 2

how is Steven Johnson’s syndrome characterized?

Answer 2

widespread erythema and macule formation resulting in epidermal detachment or sloughing and erosion formation

Question 3

Steven Johnson’s syndrome mortality rate

Answer 3

1-5%

Question 4

what can trigger Steven Johnson’s syndrome?

Answer 4

medication reactions

Question 5

what medications trigger Steven Johnson’s syndrome?

Answer 5

sulfonamides, anticonvulsants, NSAIDs, allopurinol, oxicam

Question 6

Steven Johnson’s syndrome risk factors

Answer 6

-medications
-weakened immune system (Cancer & HIV)
-history of SJS
-family history of SJS
-genetic factors

Question 7

Steven Johnson’s syndrome clinical manifestations

Answer 7

Initially:
-burning or itching
-tenderness
-flu-like symptoms (fever, cough, sore throat, headache, severe malaise, aches/pains)

Followed by:
-rapid onset of erythema involving much of the skin surface and mucous membranes

-Large bull develop or large sheets of epidermis are shed

-excruciatingly tender, loss of skin leaves a weepings surface like a total body partial thickness burn

Question 8

Steven Johnson’s syndrome Complications

Answer 8

-keratoconjunctivitis (inflammation of cornea and conductive) - impairs vision, scarring, corneal lesions
-dehydration
-respiratory failure
-sepsis
-MODS
-permanent skin damage

Question 9

Steven Johnson’s syndrome Management

Answer 9

-control of fluid and electrolyte balance
-prevention of sepsis and ophthalmic complications
-transfer to burn center
-medications: IVIG (IV immunoglobulin - blood product prepared from serum), cyclosporin, cyclophosphamide
-wound care

Question 10

Steven Johnson’s syndrome nursing interventions

Answer 10

-maintain skin & mucous membrane integrity
-attain fluid balance
-preventing hypothermia
-relieve pain
-reducing anxiety
-monitor and manage potential complications
-education