Stevens-Johnson Syndrome Flashcards
What is SJS?
An immune complex mediated hypersensitivity disorder
What does SJS form a Spectrum with?
Toxic epidermal necrolysis (TEN)
Which is less severe, SJS or TEN?
SJS
When is the disease considered SJS not TEN?
Under 10% skin surface involvement
What is SJS/TEN in terms of skin involvement?
10-30%
How much skin is involved in TEN?
> 30%
What sort of hypersensitivity reaction is SJS?
Type 4
What happens in the type 4 hypersensitivity reaction of SJS?
A Drug or Metabolite stimulate cytotoxic T cells and T helper cells to initiate autoimmune reactions that attack self-tissues
What percentage of SJS cases are caused by Medication?
75%
What percentage of SJS cases are caused by Infection and other causes?
25%
What are some examples of Medications that can cause SJS?
- Allopurinol
- Carbamazepine
- Sulfasalazine
- Antiviral agents such as Nevirapine and Abacavir
- Anticonvulsants
- NSAIDs
- Salicylates
- Sertraline
What types of infections can cause SJS?
- Viral
- Bacterial
- Fungal
- Protozoal
What viral infections can cause SJS?
- HSV
- EBV
- Enteroviruses
What bacteria can cause SJS?
- Group A beta-haemolytic strep
- Diphtheria
- Mycobacteria
What protozoa can cause SJS?
- Malaria
- Trichomoniasis
What other than infection and medications can cause SJS?
Immunisations
What immunisations can cause SJS?
- Measles
- Hep B
What are the risk factors for SJS?
- HIV/AIDS
- SLE
- Genetic factors
How does SJS often start its presentation?
With a non-specific URTI that can be associated with
- Fever
- Sore-throats
- Headache
- Arthralgia, vomiting and diarrhoea and malaise
After URTI symptoms in early SJS, how does presentation progress?
It suddenly develop Mucocutaneous lesions
How long do the outbreaks of Mucocutaneous lesions in SJS typically last?
2-4 weeks
Are SJS lesions pruritic?
Not generally
How do the mucocutaneous lesions of SJS present in the MOUTH?
As severe oromucosal ulceration
How can respiratory involvement present in SJS?
As a cough productive of thick, purulent sputum
