Stevens-Johnson Syndrome

Diagnosis

Tests and procedures used to diagnose Stevens-Johnson syndrome include a combination of medical history review, physical examination, and focused laboratory investigations. Health care providers often identify the condition based on recent or current medications and visible symptoms on the skin and mucous membranes. A skin biopsy is typically performed to confirm the diagnosis and to rule out other possible causes. Samples of skin, tissue, or fluid may be taken for laboratory culture to check for infections. Blood tests may be done to identify infections or other triggers. Depending on symptoms, imaging such as a chest X-ray may be recommended to check for pneumonia.

More Information
Skin biopsy

Treatment

Treating Stevens-Johnson syndrome requires hospital care, often in an intensive care unit or a burn unit due to the seriousness of the condition. The first step is stopping any medications suspected of causing the reaction. If more than one drug is being taken, it may be difficult to identify the cause, so your health care provider may recommend stopping all nonessential medications.

Supportive care in the hospital may include:
• Fluid replacement and nutrition to prevent dehydration and support recovery, often through a tube inserted through the nose into the stomach
• Wound care such as cool, wet compresses to soothe blisters, gentle removal of dead skin, and application of petroleum jelly or medicated dressings
• Eye care from an ophthalmologist if the eyes are affected

Medications used in treatment may include pain relievers for comfort, topical steroids to reduce inflammation of the eyes and mucous membranes, and antibiotics when infection is present. Other systemic medications, such as corticosteroids and intravenous immune globulin, may be used. Studies show that cyclosporine and etanercept can also help treat the disease. When the underlying cause is removed and the skin reaction stops, new skin may begin to grow within a few days, though recovery from severe cases may take several months.