What is Steven-Johnson Syndrome (SJS)?
Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe skin reactions that cause sheet-like skin and mucosal loss. Mucosal involvement is a key diagnostic factor in the early stages.
Who is at risk?
SJS/TEN can affect all ages, races, and sexes but is more common in females. People with HIV have a much higher risk. SJS related to infections is more common in children, and medication-induced SJS/TEN is more common in adults.
What are the signs and symptoms?
SJS/TEN begins with flu-like symptoms, including fever, sore throat, cough, runny nose, conjunctivitis, and general aches. These symptoms are followed by the sudden onset of a painful red rash that spreads quickly across the trunk, face, and limbs. The rash can include macules, widespread redness, target-shaped lesions, and flaccid blisters that merge into sheets of skin detachment. A positive Nikolsky sign is often present, meaning gentle rubbing leads to blisters and erosions. The rash usually starts on the trunk and spreads to the face and limbs. It rarely affects the scalp, palms, or soles. Mucosal involvement affects at least two mucosal surfaces, including the eyes, mouth/lips, pharynx/esophagus, genitalia, urinary tract, and upper respiratory tract.