Stevens-Johnson syndrome (SJS) is a rare and serious disorder that requires hospitalization. It impacts the skin and mucous membranes and is usually distinguished by a painful rash that can spread and blister. There are some researchers who believe that SJS is a separate disease from toxic epidermal necrolysis (TEN). However, others believe the two to be the same disease that comes in differing levels. For example, TEN is also a serious skin condition that can cause rashes and blistering, but it is more intense than SJS.
Within this article, we are going to be observing what is SJS. Additionally, we will discuss SJS in relation to drug side effects. Please note that I am not a doctor. Although this article has undergone extensive research to try to provide accurate and up-to-date information, do not replace this article with your doctor’s advice. Contact your doctor if you have any questions or concerns.
What is Stevens-Johnson Syndrome?
As previously mentioned, SJS is a serious skin disorder in which the skin can become painful and lead to rashes, blisters, and/or peeling. Another name for it is Lyell’s syndrome or erythema multiforme major. It may also be called something else depending on the cause, such as mycoplasma-induced Stevens-Johnson syndrome. For example, if it was caused by a drug reaction, it may be called drug-induced Stevens-Johnson syndrome.
SJS can appear in anyone under the age of 30 years. However, it can cause problems in older adults as well. Additionally, people with a family history of SJS may be more likely to have the condition. Let your doctor know if you or any of your family members experienced SJS.
Symptoms
There are several symptoms of SJS, including the following:
- Flu-like symptoms (fever, coughing, headache, sore mouth and throat)
- Tiredness
- Eye irritation
- Skin pain
- Red or purple rash
- Blisters
If your condition worsens or persists, contact your doctor immediately. If you believe your condition or symptoms appear to be life threatening, stop taking all nonessential medications and call 911. Individuals are more likely to experience flu-like symptoms at first, which can then be followed by rashes or blisters on the skin.
Causes
Depending on your condition, it may be difficult for your doctor to identify the specific cause of SJS. Certain drugs or infections may cause the disorder. Because it is a rare and unpredictable disease, there may not be an identifiable cause in which the syndrome becomes idiopathic. At least 100 drugs can cause SJS. In several cases an allergic reaction to medicines can cause SJS. However, in other cases infections as well as vaccinations can cause SJS. Below is a list of more common causes of SJS:
Drugs
- Anti-gout medicines (allopurinol)
- Medications that help treat seizures and mental illness (anticonvulsants and antipsychotics)
- Medications that help fight infection (penicillin)
- Pain relievers (acetaminophen, ibuprofen, naproxen sodium)
Infections and Other Conditions
- Hepatitis A
- Herpes virus
- HIV
- Pneumonia (especially in children)
- Bone marrow transplant
- Systemic lupus erythematosus
- Other chronic conditions related to the joints and connective tissue
Treatment
SJS is treatable by a medical professional. It requires hospitalization and often involves treatment in a burn center or intensive care unit. The first thing your doctor may ask is that you stop taking any medications that may be causing your reaction. Additionally, you may be required to stop taking all nonessential medications if it is too difficult to discern the cause of your condition. Other treatment processes may involve supportive care and/or other medications, such as pain medication.
Drugs Associated with SJS
Earlier in this article we discussed that there are several possible causes of SJS. More specifically, several cases demonstrate that drugs can lead to SJS. Drug side effects can range from common to severe. The most common drugs that are associated with SJS include: allopurinol, anticonvulsants, antipsychotics, acetaminophen, nevirapine, sulfonamides, and certain NSAIDs. Some of these drugs are prescribed to patients with fibromyalgia, HIV/AIDS, lupus, and other conditions.
More specifically, here is a list of common drugs associated with SJS in relation to other conditions:
- Acetaminophen: mild to moderate pain (headaches, osteoarthritis, fibromyalgia), fever
- Allopurinol: kidney stones, gout (a form of arthritis)
- Anticonvulsants (carbamazepine, lamotrigine, and phenytoin): seizures
- Antipsychotics: schizophrenia, bipolar disorder, fibromyalgia
- Nevirapine: HIV infection
- NSAIDs (oxicams): pain, fever, inflammation, anti-thrombosis
- Sulfonamides: class of antibiotic drugs
There may be more corresponding drugs or conditions not listed above. Other factors may also cause or trigger SJS. Talk to your doctor about other possible causes of SJS. Also, if you have any questions or concerns, reach out to a medical professional you trust.
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