Stevens-Johnson syndrome - Revision history

Aidan at 20:04, 13 April 2026

2026-04-13T20:04:03Z

← Older revision		Revision as of 20:04, 13 April 2026
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	*Infection: especially common in children		*Infection: especially common in children
	**[[Mycoplasma pneumoniae]]: moderate to severe involvement of two or more mucosal sites and sparse, or even absent, skin involvement		**[[Mycoplasma pneumoniae]]: moderate to severe involvement of two or more mucosal sites and sparse, or even absent, skin involvement (though this is usually now considered a separate entity called [[RIME]])
	**[[Neisseria gonorrhoeae]][[CiteRef::tan2012pr]]		**[[Neisseria gonorrhoeae]][[CiteRef::tan2012pr]]
	*Drugs		*Drugs
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	* [[Erythema multiforme]]		* [[Erythema multiforme]]
	* [[Coxsackievirus]]		* [[Coxsackievirus]]
			* [[Reactive infectious mucocutaneous eruption]] (RIME)
	* [[Mycoplasma pneumoniae]]
	* Linear IgA bullous dermatosis		* Linear IgA bullous dermatosis
	* Generalized bullous fixed-drug eruption		* Generalized bullous fixed-drug eruption
	* Methotrexate toxicity		* [[Methotrexate]] toxicity
	* [[Graft-versus-hosts disease]]		* [[Graft-versus-hosts disease]]
	* [[Staphylococcal scalded skin syndrome]]		* [[Staphylococcal scalded skin syndrome]]

Aidan at 00:35, 7 January 2026

2026-01-07T00:35:06Z

← Older revision		Revision as of 00:35, 7 January 2026
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	* Onset typically 1 to 3 weeks, but ranges from a few days up to 8 weeks		* Onset typically 1 to 3 weeks, but ranges from a few days up to 8 weeks
	* Characterized by large blisters, large areas of skin detachment, confluent areas of erythema, atypical target lesions, purpura		* Characterized by large blisters, large areas of skin detachment, confluent areas of erythema, atypical target lesions, purpura
	* Nikolsky sign		* [[Nikolsky sign]]
	* Classified as SJS if less than 10% body surface area involved, or TEN if ≥30%		* Classified as SJS if less than 10% body surface area involved, or TEN if ≥30%
	* May have fever or influenza-like illness		* May have fever or influenza-like illness
	* May have respiratory symptoms		* May have respiratory symptoms
	* May have lymphopenia and AKI		* May have lymphopenia and AKI

			=== Prognosis ===

			* Mortality is 10 to 40%, depending on severity
			* Can develop superimposed bacterial infections
			* After withdrawal of the offending drug, re-epithelialization starts around 1 week and lasts up to 3 weeks
			* Can result in permanent scarring, hyperpigmentation, alopecia, nail loss, vision loss, synechiae, dry eye, dental problems

			== Differential Diagnosis ==

			* [[Erythema multiforme]]
			* [[Coxsackievirus]]
			* [[Mycoplasma pneumoniae]]
			* Linear IgA bullous dermatosis
			* Generalized bullous fixed-drug eruption
			* Methotrexate toxicity
			* [[Graft-versus-hosts disease]]
			* [[Staphylococcal scalded skin syndrome]]
			* [[Systemic lupus erythematosus]]
			* [[Pemphigus vulgaris]]

	== Diagnosis ==		== Diagnosis ==

			* Diagnosis is based on histopathology of a skin biopsy, which will show full-thickness epidermal necrosis, focal adnexal necrosis, necrotic keratinocytes, and mild mononuclear cell dermal infiltrate
			** Negative direct immunofluorescence tests

	== Management ==		== Management ==

Aidan: /* Clinical Manifestations */

2026-01-07T00:26:35Z

Clinical Manifestations

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 ==Etiology==
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 * Onset typically 1 to 3 weeks, but ranges from a few days up to 8 weeks
 == Management ==

Aidan at 19:42, 3 October 2025

2025-10-03T19:42:57Z

← Older revision		Revision as of 19:42, 3 October 2025
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	***[[Levofloxacin]]		***[[Levofloxacin]]
	***[[Rifampin]]		***[[Rifampin]]

			== Clinical Manifestations ==

			* Onset typically 1 to 3 weeks, but ranges from a few days up to 8 weeks

	== Management ==		== Management ==

Aidan: /* Management */

2024-04-10T13:39:16Z

Management

← Older revision		Revision as of 13:39, 10 April 2024
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	*Stop offending drug, if applicable		*Stop offending drug, if applicable
	*Supportive care, including wound care and IV fluids (2 ml per kg times BSA over first 24 hours)		*Supportive care, including wound care and IV fluids (2 ml per kg times BSA over first 24 hours)
	**Room temperature 30 to 32 C		**Room temperature 30º to 32ºC
	**May need NG tube		**May need NG tube
	**Pain control, as pain may be severe		**Pain control, as pain may be severe

Aidan at 21:37, 20 March 2022

2022-03-20T21:37:55Z

← Older revision		Revision as of 21:37, 20 March 2022
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	* Risk stratify with [[SCORTEN score]]		* Risk stratify with [[SCORTEN score]]
	* Consider referral to burn centre or ICU		* Consider referral to burn centre or ICU if [[BSA]] 30% or greater, or if SCORTEN score is 2 or greater
			*Stop offending drug, if applicable
	*
			*Supportive care, including wound care and IV fluids (2 ml per kg times BSA over first 24 hours)
			**Room temperature 30 to 32 C
			**May need NG tube
			**Pain control, as pain may be severe
			*Ophthalmologic exam and management
			**Saline rinses
			**Artificial tears even if no involvement
			**Corticosteroids with or without antibiotics for any involvement
			*No clear benefit to steroids or IVIG
			*Cyclosporine 3 to 5 mg per kg in one or two divided doses may slow progression

Aidan at 21:09, 20 March 2022

2022-03-20T21:09:36Z

← Older revision		Revision as of 21:09, 20 March 2022
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	***[[Levofloxacin]]		***[[Levofloxacin]]
	***[[Rifampin]]		***[[Rifampin]]

			== Management ==

			* Risk stratify with [[SCORTEN score]]
			* Consider referral to burn centre or ICU
			*

Aidan: /* Etiology */

2020-08-05T14:16:21Z

Etiology

← Older revision		Revision as of 14:16, 5 August 2020
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	== Etiology ==		==Etiology==

	* Infection: especially common in children		*Infection: especially common in children
	** [[Mycoplasma pneumoniae]]: moderate to severe involvement of two or more mucosal sites and sparse, or even absent, skin involvement		**[[Mycoplasma pneumoniae]]: moderate to severe involvement of two or more mucosal sites and sparse, or even absent, skin involvement
	** [[Neisseria gonorrhoeae]][[CiteRef::tan2012pr]]		**[[Neisseria gonorrhoeae]][[CiteRef::tan2012pr]]
	* Drugs		*Drugs
	** Allopurinol		**[[Allopurinol]]
	** Aromatic antiepileptic drugs and lamotrigine		**Aromatic [[antiepileptic drugs]] and [[lamotrigine]]
	** Antibacterial sulfonamides (including [[sulfamethoxazole]] and sulfasalazine)		**Antibacterial sulfonamides (including [[sulfamethoxazole]] and [[sulfasalazine]])
	** [[Nevirapine]]		**[[Nevirapine]]
	** Oxicam nonsteroidal anti-inflammatory drugs (NSAIDs)		**[[Oxicam]] nonsteroidal anti-inflammatory drugs (NSAIDs)
	** Less strongly, other antibiotics		**Less strongly, other antibiotics
	*** [[Doxycycline]]
	*** [[~~Amoxicillin]]/[[ampicillin~~]]		***[[Doxycycline]]
	*** [[~~Ciprofloxacin~~]]		***[[Amoxicillin]]/[[ampicillin]]
	*** [[~~Levofloxacin~~]]		***[[Ciprofloxacin]]
	*** [[~~Rifampin~~]]		***[[Levofloxacin]]
			***[[Rifampin]]

Aidan: /* Etiology */

2019-12-21T01:13:32Z

Etiology

← Older revision		Revision as of 01:13, 21 December 2019
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	* Infection: especially common in children		* Infection: especially common in children
	** [[Mycoplasma pneumoniae]]: moderate to severe involvement of two or more mucosal sites and sparse, or even absent, skin involvement		** [[Mycoplasma pneumoniae]]: moderate to severe involvement of two or more mucosal sites and sparse, or even absent, skin involvement
	** [[Neisseria ~~gonorrhoea~~]][[CiteRef::tan2012pr]]		** [[Neisseria gonorrhoeae]][[CiteRef::tan2012pr]]
	* Drugs		* Drugs
	** Allopurinol		** Allopurinol

Aidan: Created page with " == Etiology == * Infection: especially common in children ** Mycoplasma pneumoniae: moderate to severe involvement of two or more mucosal sites and sparse, or even absent..."

2019-11-15T04:14:57Z

Created page with " == Etiology == * Infection: especially common in children ** Mycoplasma pneumoniae: moderate to severe involvement of two or more mucosal sites and sparse, or even absent..."

New page

== Etiology ==
* Infection: especially common in children
** [[Mycoplasma pneumoniae]]: moderate to severe involvement of two or more mucosal sites and sparse, or even absent, skin involvement
** [[Neisseria gonorrhoea]][[CiteRef::tan2012pr]]
* Drugs
** Allopurinol
** Aromatic antiepileptic drugs and lamotrigine
** Antibacterial sulfonamides (including [[sulfamethoxazole]] and sulfasalazine)
** [[Nevirapine]]
** Oxicam nonsteroidal anti-inflammatory drugs (NSAIDs)
** Less strongly, other antibiotics
*** [[Doxycycline]]
*** [[Amoxicillin]]/[[ampicillin]]
*** [[Ciprofloxacin]]
*** [[Levofloxacin]]
*** [[Rifampin]]