Stevens-Johnson syndrome (SJS) is a rare, serious disorder of the skin and mucous membranes. It is usually a reaction to medication that starts with flu-like symptoms, followed by a rash that spreads and blisters. The top layer of affected skin dies, sheds, and begins to heal after several days. Sometimes the injured skin can progress to deeper layers of the skin and may require surgical intervention or skin grafting. Treatment focuses on removing the cause, caring for wounds, controlling pain, and minimizing complications as skin regrows. It can take weeks to months to recover. A more severe form of the condition is called toxic epidermal necrolysis (TEN); it involves more than 30% of the skin surface and extensive damage to the mucous membranes. SJS/TEN is used to designate skin involvement of 10-30% TBSA.

These syndromes are usually associated with a drug reaction, often to antibiotics or seizure medications. The symptoms usually develop within several days of starting the medication. Macrolide antibiotics such as Biaxin have commonly been implicated as a cause of SJS or TENS.

1. Joseph L. Nates and Kristen J. Price, Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) Immunologic Reactions.

2. Oncologic Critical Care. 2019 Jul 9: 267-280. 2019 Jul 9. doi: 10.1007/978-3-319-74588-6_195.

3. Pejcic, AV. Stevens-Johnson syndrome and toxic epidermal necrolysis associated with the use of macrolide antibiotics: a review of published cases Int J Dermatol, 2021 Jan;60(1):12-24. doi: 10.1111/ijd.15144. Epub 2020 Aug 17.

    IF YOU NEED A STEVENS-JOHNSON (SJS)/TOXIC EPIDERMAL NECROLYSIS (TEN) MEDICAL EXPERT, CALL MEDILEX AT (212) 234-1999.

   
   Image courtesy of James Heilman, MD. Title: Mucosal desquamation in a person with Stevens–Johnson syndrome. This file is licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license.