Steven-Johnson Syndrome

AKA Erythema Multiforme Major

  • Usually due to a drug reaction
  • Always mucous membranes involvement
  • Extensive erythematous vesicular eruptions

Nikolsky’s Sign

  • Extension of blisters with gentle sliding pressure

Clinical features:

  • Systemic symptoms
  • Fever
  • Prostration (extreme exhaustion/ weakness)
  • Cheilitis (inflammation of the lips)
  • Stomatitis (inflammation inside mouth)

Other points:

  • Vulvovaginitis / balanthitis May cause difficulty micturating
  • Conjunctivitis and keratitis carry a risk of scarring and permanent visual impairment
  • Lesions in pharynx / larynx necessitate ENT review

Causes

In kids:

  • Viral infection
  • Mumps
  • Flu
  • Herpes simplex
  • Coxsackie virus
  • Epstein Barr

In adults:

  • Allopurinol
  • Carbamazepine
  • Co-trimazole
  • Lamotragine
  • NSAIDs meloxicam/peroxicam
  • Phenobarbital
  • Phenyltoin
  • Sertraline