What disease did Stevens have? Stevens-Johnson syndrome: what it is, symptoms, diagnosis, treatment

Stevens Johnson syndrome is a very severe disease of a systematic delayed-type allergic reaction that occurs as a multiform exudative erythema affecting least of all the mucous membrane of two organs, maybe more.

Reasons

The causes of Steven Johnson syndrome can be divided into subgroups:

• medications. An acute allergic reaction occurs when a medication enters the body. Main groups causing the syndrome Steven Johnson: antibiotics penicillin series, non-steroidal anti-inflammatory drugs, sulfonamides, vitamins, barbiturates, heroin;
• infections. In this case, the infectious-allergic form of Steven Johnson syndrome is recorded. Allergens are: viruses, mycoplasmas, bacteria;
• oncological diseases;
• idiopathic form Stevens Johnson syndrome. In such a situation, clear reasons cannot be determined.

Clinical picture

Steven Johnson syndrome appears at a young age from 20 to 40 years, but there are times when this disease is diagnosed in newborn children. Men are more often affected than women.

The first symptoms affect the upper system respiratory tract. The initial prodromal period is extended to two weeks and is systematized by a febrile state, severe weakness, cough, headaches appear. In rare cases, vomiting and diarrhea are caused.

The skin and mucous membranes of the mouth in children and adults are affected instantly within five days; the location can be anywhere, but most often a rash occurs on the elbows, knees, face, reproductive organs and all mucous membranes.

With Steven Johnson syndrome, swollen, compacted papules of a dark pink color appear, round in shape, the diameter of which is from one to six centimeters. There are two zones: internal and external. The internal ones are characterized by a grayish-blue color, in the middle a bubble appears inside which contains serous fluid. The outer one appears in red.

In the oral cavity, on the lips, cheeks in children and adults, Stevens John syndrome is manifested by broken erythema, blisters, and erosive areas of a yellowish-gray color. When the blisters open, bleeding wounds form; lips and gums swell, hurt, and become covered with hemorrhagic crusts. The rash on all areas of the skin feels burning and itching.

In the urine excretory system, mucous membranes are affected and is manifested by bleeding from the urine excretory tract, a complication of the urethra in men, and vulvovaginitis in girls. The eyes are also affected, in which case blephoroconjunctivitis progresses, which often leads to complete blindness. Rarely, but the development of colitis and proctitis is possible.

There are also general symptoms: fever, headaches and joint pain. Malignant exudative erythema develops in people over forty years of age, acute and very rapid, heart contractions become frequent, hyperglycemia. Symptoms when affected internal organs, namely their mucous membranes manifest themselves in the form of stenosis of the esophagus.

The final fatality rate for Steven Johnson syndrome is ten percent. Complete loss of vision after severe keratitis caused by Stephen John syndrome is observed in five to ten patients.

Exudative erythema multiforme is diagnosed together with Lyell's syndrome. It is held between them. In both of these diseases the primary lesions are similar. They may also be similar to systemic vasculitis.

Video: The Scary Reality About Stevens-Johnson Syndrome

Stevens-Johnson syndrome is a severe stage of erythema multiforme, in which blisters form on the mucous membranes of the mouth, eyes, throat, reproductive organs and other areas of the skin and mucous membranes.

The causes of the development of the disease are allergies that developed while taking an antibiotic or antibacterial drug. This disease can develop due to heredity. In this case, the body independently fights Steven-Johnson syndrome.

During the course of the disease, intoxication of the body and the development of allergies are observed. The disease develops quickly. The following symptoms appear:

• high fever;
• muscle and joint pain;
• damage to the oral mucosa;
• the appearance of bubbles.

The eyes are affected by the type of conjunctivitis, but the inflammation is allergic in nature. Then a bacterial infection occurs, against the background of which the patient’s general condition sharply worsens. Then small ulcers appear and the cornea becomes inflamed.

If the inflammation has spread to the genitals, then urethritis or vulvovaginitis is diagnosed. Late symptoms of Stephen Jones disease are associated with skin lesions. Blisters that appear on the skin are round in shape and purple in color. The diameter of the spots ranges from 1-5 cm. Inside the blisters there is a clear watery liquid or blood.

If you open them, then in their place there will be defects of a bright red hue. Then a crust appears. More often, Stevens-Johnson syndrome is diagnosed on the torso and perineum. In this case, the general condition of the patient is disturbed. The patient exhibits the following symptoms:

• fever;
• dizziness;
• weakness;
• fatigue.

The above symptoms are observed within 2-3 weeks. Doctors include pneumonia, diarrhea, and kidney failure as complications of the disease. Stevens Johnson syndrome is fatal in 10% of cases.

Diagnostic methods

Used to diagnose the disease various methods research. In a general blood test, laboratory technicians detect high content leukocytes, the presence of their young forms and special cells that are responsible for the development of allergies. This increases the erythrocyte sedimentation rate.

Such phenomena are nonspecific and occur with any inflammatory disease. To diagnose Stevens-Johnson syndrome, a biochemical blood test is performed (high levels of bilirubin, urea and aminotransferase).

The patient has poor clotting blood. It's happening in the background low content protein (fibrin), which is responsible for clotting. As a result, the content of enzymes that are responsible for the breakdown of fibrin increases.

The total protein content in the blood decreases. Experts recommend conducting such a specific study as an immunogram. This diagnostic method allows you to detect a high content of T-lymphocytes and some specific antibodies in the blood.

The doctor makes a diagnosis after a complete examination of the patient. The patient must inform the doctor about his living conditions, diet, medications taken, working conditions, allergies, current ailments, and hereditary diseases.

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Treatment is prescribed taking into account:

• dates of onset of illness;
• various factors that preceded the disease;
• list of medications taken.

To evaluate external symptoms illness, the patient needs to undress. The doctor examines the skin and mucous membranes. Stevens Johnson syndrome is often confused with Lyell's syndrome and pemphigus.

Based on the results obtained, an appropriate course of treatment is prescribed. A patient diagnosed with the syndrome in question is hospitalized in the department intensive care. Stevens-Johnson disease is treated with general and local therapy. At general methodology treatment is prescribed to the patient high dosage corticosteroid medications, antihistamines and antibacterial drugs.

Therapeutic measures

Local treatment of the disease in question consists of taking the following remedies:

• anesthetic solutions and ointments (in the presence of severe pain);
• antiseptic solutions (for treating affected areas);
• ointments based on glucocorticosteroids;
• epithelializing medications, the action of which accelerates the healing of affected elements.

Before treating damage to other organs, you will need the help of specialized doctors, including an ophthalmologist, ENT specialist, cardiologist, pulmonologist, and gastroenterologist.

More often, patients suffering from Stevens-Johnson syndrome are prescribed drugs of adrenal hormones. The dosage is selected taking into account the degree of damage to the body. The drugs are administered until the patient’s general well-being improves. Then the doctor reduces the dosage of the drug. The course of treatment lasts 1 month.

At severe course illness, the drug is not taken orally. It is administered intravenously. In this case, liquid hormones are used. To remove antigens from the patient’s body, special medications and blood purification methods (hemosorption, plasmapheresis) are used.

At mild form for illness, they take pills that help remove toxins from the body through the intestines. To prevent body intoxication, it is recommended to drink 2-3 liters of liquid daily. During the course of treatment, it is necessary to ensure that this volume of fluid is promptly removed from the body. Otherwise, serious complications may develop. Such conditions can only be observed when the patient is hospitalized.

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If necessary, the doctor performs intravenous transfusion of protein and plasma solutions. Additionally, the patient may be prescribed medications that contain calcium and potassium. If allergies develop, take antiallergic drugs (“Suprastin”).

Complications and prognosis

If large areas of skin are affected, then an infectious process may develop. In this case, treatment of the syndrome consists of taking antibacterial agents and antifungal drugs. You can take “ Activated carbon” (1 tablet per 10 kg). This drug is taken in the morning on an empty stomach. Stevens Johnson syndrome should not be treated without consulting a doctor.

For treatment skin rash They use a special cream that contains preparations of adrenal hormones. Antiseptics are used to prevent infection. The syndrome in question is observed at any age. It is diagnosed more often in men than in women. Folk remedies can be used if they are recommended by the attending physician.

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Prevention re-development disease is to avoid taking various medications and biological supplements. You must first consult your doctor. Treatment of Stevens-Johnson syndrome is prescribed after determining the type of allergen (in case of predisposition to allergies). Doctors include complications of the pathology in question:

• blindness that develops against the background of secondary keratitis;
• stenosis of the digestive organs;
• narrowing of the urinary canal;
• diseases of the mucous membranes;
• tachycardia;
• damage to more than 10% of the epidermis.

The prognosis of the disease is favorable. This depends on the severity of the disease, the presence of various complications and the patient’s immunity.

Stevens-Johnson syndrome (SJS) is rare, but serious disorder, which affects the skin and mucous membranes. This is an overreaction of the body's immune system to a trigger, such as a drug or infection. .

It was named after pediatricians A. M. Stevens and S. C. Johnson, who diagnosed a child with a serious reaction to an eye and mouth drug in 1922.

SJS causes blistering, peeling of the skin and surfaces of the eyes, mouth, throat, and genitals.

Facial swelling, a diffuse reddish or purple rash, blisters and swollen lips covered with sores are general features Stevens-Johnson syndrome. If the eyes are affected, it can lead to corneal ulcers and vision problems.

SJS is one of the most debilitating adverse drug reactions (ADRs). Adverse drug reactions (ADRs) account for approximately 150,000 deaths per year, making them the fourth leading cause of death.

Stevens-Johnson syndrome is rare because the overall risk of getting it is one in 2 to 6 million per year.

SJS requires urgent medical care for the most severe form, called toxic epidermal necrolysis. The two conditions can be differentiated depending on total area body surface (TBSA). SJS is comparatively less pronounced and covers 10% of TBSA.

Toxic epidermal necrolysis (TEN) is the most serious form of the disease, affecting 30% or more of TBSA. SJS most often occurs in children and the elderly. SCORTEN is a disease severity score that was developed to predict mortality in cases of SJS and TEN.

Causes of Stevens Johnson syndrome include the following:

Medicines

This is the most common reason. Within a week of starting the drug, a reaction occurs, although it can happen even after a month or two, for example. Particularly implicated in the syndrome are the following drugs:

• Antibiotics:
  • Sulfonamides or sulfa drugs such as cotrimoxazole;
  • Penicillins: amoxicillin, bacampicillin;
  • Cephalosporins: cefaclor, cephalexin;
  • Macrolides, which are antibiotics wide range; actions: azithromycin, clarithromycin, erythromycin;
  • Quinolones: ciprofloxacin, norfloxacin, ofloxacin;
  • Tetracyclines: doxycycline, minocycline;

• Anticonvulsants are used to treat epilepsy to prevent seizures.

Medicines such as lamotrigine, carbamazepine, phenytoin, phenobarbitone, and in particular the combination of lamotrigine with sodium valproate increase the risk of Stevens Johnson syndrome.

• Allopurinol, which is used to treat gout
• Acetaminophen, considered safe medicine for everyone age groups
• Nevirapine, a non-nucleoside reverse transcriptase inhibitor, is used to treat HIV infection
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are pain relievers: diclofenac, naproxen, indomethacin, ketorolac

Infections

Infections that may predispose include:

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• Viral infections. With viruses: swine flu, influenza, herpes simplex, Epstein-Barr virus, hepatitis A, HIV are associated with SJS.

In pediatric cases, Epstein-Barr virus and enteroviruses have been particularly toxic.

• Bacterial infections. Such as mycoplasma pneumonia, typhoid fever, brucellosis, lymphogranuloma venereism.
• Protozoal infections: malaria, trichomoniasis.

Factors that increase the risk of SJS are:

• Genetic factors - the chromosomal variations most strongly associated with Stevens-Johnson syndrome occur in the HLA-B gene. Studies indicate a strong association between the HLA-A*33:03 and HLA-C*03:02 alleles and allopurinol-induced SJS or TEN, especially in Asian populations. The risk of suffering is higher if a close family member has been affected, also indicating a possible underlying genetic risk factor.
• Weakened immune system. A depleted immune system as a result of HIV infection, autoimmune conditions, chemotherapy, or organ transplantation may predispose people to developing the disorder.
• Previous history of Stevens-Johnson syndrome. There is a risk of recurrence if the same medications or medications from the same group that previously caused the reaction were taken.

Symptoms and signs

1. Symptoms similar to upper respiratory tract infections, such as fever > 39°C, sore throat, chills, cough, headache, pain throughout the body
2. Target lesions. These lesions, which are darker in the middle surrounded by lighter areas, are considered diagnostic
3. Painful red or purple rash, blisters on the skin, mouth, eyes, ears, nose, genitals. As the disease progresses, the flaccid blisters may coalesce and rupture, causing painful sores. Eventually the top layer of skin forms a crust.
4. Facial swelling, swollen lips covered with ulcers, mouth ulcers. Throat ulcers cause difficulty swallowing, and diarrhea may occur, causing dehydration
5. Swelling, swelling of the eyelids, inflammation of the conjunctiva, photosensitivity when the eyes are sensitive to light

Diagnostics

The diagnosis of Stevens-Johnson syndrome is based on the following:

1. Clinical examination—a thorough clinical history that identifies predisposing factors and the presence of a characteristic target rash plays a key role in diagnosis.
2. Skin biopsy helps confirm the diagnosis.

Treatment

Stevens-Johnson syndrome requires immediate hospitalization.
First, you need to stop taking the medication, presumably causing symptoms

Treatment of damage to the skin and mucous membranes

• Dead skin is carefully removed, and a protective ointment is applied to the affected areas to protect them from infection until they heal.

Dressings with biosynthetic skin substitutes or non-adhesive nanocrystalline silver mesh can be used

• • Antibiotics and local antiseptics are used to treat the infection. Tetanus immunization may be given to prevent infection.

• Intravenous immunoglobulins (IVIG) are given to stop the disease process.

It is unclear whether corticosteroids, medications used to fight inflammation, reduce mortality or hospital stay, are helpful for toxic epidermal necrolysis and Stevens-Johnson syndrome, as they may increase the chances of infection.

• Mouth rinses and local anesthesia are prescribed to relieve pain in the mouth, throat, and to promote oral intake.
• The eyes are treated with ointment or artificial tears to stop the surface from drying out. Topical steroids, antiseptics, and antibiotics can be used to prevent inflammation and infection.

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Surgical treatment, such as PROSE (Prosthetic Ocular Surface Ecosystem Replacement) treatment, may be required for chronic ocular surface disease.

• Vaginal steroid ointments used in women to prevent the formation of scar tissue in the vagina

Other treatments

• Nutritional and liquid replacement food through a nasogastric tube or intravenously to prevent and treat dehydration and maintain nutrition;
• Maintaining a temperature of 30-32 ° C in case of violation of body temperature regulation;
• Analgesics, analgesics for pain relief;
• Intubation, mechanical ventilation, will be required if the trachea (breathing tube), bronchi are affected, or the patient has breathing problems;
• Psychiatric support for extreme anxiety and emotional lability, if present.

Prevention

It is very difficult to predict which patients will develop this disease. However,

• If a close family member has had this reaction to a particular drug, it is best to avoid using a similar drug or other drugs that belong to the same chemical group.

Always tell your doctor about your loved ones' reactions so that the doctor does not prescribe a possible allergen.

• If Stevens-Johnson syndrome is caused by an adverse reaction to a drug, avoid taking it and other chemically related substances in the future.
• Genetic testing is rarely recommended.

For example, if you are of Chinese, Southeast Asian descent, you may have genetic testing to determine whether genes (HLA B1502; HLA B1508) that are associated with the disorder or caused by the drugs carbamazepine or allopurinol are present.

Stevens-Johnson syndrome(malignant exudative erythema) is a very severe form of erythema multiforme, in which blisters appear on the mucous membrane of the mouth, throat, eyes, genitals, and other areas of the skin and mucous membranes.

Damage to the oral mucosa makes it difficult to eat; closing the mouth causes severe pain, which leads to drooling. The eyes become very painful, swollen and filled with pus so that the eyelids sometimes stick together. The corneas undergo fibrosis. Urination becomes difficult and painful.

What triggers / Causes of Stevens-Johnson Syndrome:

The main reason for the occurrence Stevens-Johnson syndrome is the development of an allergic reaction in response to taking antibiotics and other antibacterial drugs. Currently, a hereditary mechanism for the development of pathology is considered very likely. As a result of genetic disorders in the body, its natural defenses are suppressed. In this case, not only the skin itself is affected, but also the blood vessels that feed it. It is these facts that determine all developing clinical manifestations diseases.

Pathogenesis (what happens?) during Stevens-Johnson Syndrome:

The disease is based on intoxication of the patient’s body and the development of allergic reactions in it. Some researchers tend to consider pathology as a malignant type of multimorphic exudative erythema.

Symptoms of Stevens-Johnson Syndrome:

This pathology always develops in the patient very quickly, rapidly, since in essence it is an immediate allergic reaction. Initially, severe fever and pain in the joints and muscles appear. Subsequently, after just a few hours or a day, damage to the oral mucosa is detected. Here bubbles of quite large sizes appear, skin defects covered with gray-white films, crusts consisting of clots of dried blood, and cracks.

Defects also appear in the area of ​​the red border of the lips. Eye damage occurs as conjunctivitis (inflammation of the mucous membranes of the eyes), however inflammatory process here is purely allergic in nature. In the future, bacterial damage may also occur, as a result of which the disease begins to progress more severely, and the patient’s condition sharply worsens. On the conjunctiva with Stevens-Johnson syndrome may also appear minor defects and ulcers, inflammation of the cornea and posterior parts of the eye (retinal vessels, etc.) may occur.

Lesions can often also involve the genitals, which manifests itself in the form of urethritis (inflammation urethra), balanitis, vulvovaginitis (inflammation of the female external genitalia). Sometimes mucous membranes in other places are involved. As a result of skin damage, large number spots of redness with raised areas above the skin level, similar to blisters. They have rounded outlines and a purple color. In the center they are bluish and seem to be somewhat sunken. The diameter of the lesions can range from 1 to 3-5 cm. In the central part of many of them, blisters form, which contain a transparent watery liquid or blood inside.

After opening the blisters, bright red skin defects remain in their place, which are then covered with crusts. Mostly, the lesions are located on the patient’s torso and in the perineal area. Very pronounced violation general condition patient, which manifests itself in the form of high fever, malaise, weakness, fatigue, headache, dizziness. All these manifestations last on average about 2-3 weeks. Complications during the disease may include pneumonia, diarrhea, kidney failure, etc. In 10% of all patients, these diseases are very severe and lead to death.

Diagnosis of Stevens-Johnson Syndrome:

When conducting general analysis blood reveals an increased content of leukocytes, the appearance of their young forms and specific cells responsible for the development of allergic reactions, an increase in the erythrocyte sedimentation rate. These manifestations are very nonspecific and occur in almost all inflammatory diseases. At biochemical research blood, it is possible to detect an increase in the content of bilirubin, urea, and aminotransferase enzymes.

The clotting ability of blood plasma is impaired. This is due to a decrease in the content of the protein responsible for coagulation - fibrin, which, in turn, is a consequence of an increase in the content of enzymes that carry out its breakdown. The total protein content in the blood also becomes significantly reduced. The most informative and valuable in this case is to conduct a specific study - an immunogram, during which a high content of T-lymphocytes and certain specific classes of antibodies in the blood is detected.

For staging correct diagnosis in case of Stevens-Johnson syndrome, it is necessary to interview the patient as fully as possible about his living conditions, the nature of his diet, and medicines ah, working conditions, diseases, especially allergic ones, among parents and other relatives. The time of onset of the disease, the effect on the body of various factors that preceded it, especially the intake of medicines. Are being assessed external manifestations diseases, for which it is necessary to undress the patient and carefully examine the skin and mucous membranes. Sometimes it is necessary to distinguish the disease from pemphigus, Lyell's syndrome and others, but in general, making a diagnosis is a fairly simple task.

Treatment of Stevens-Johnson Syndrome:

Preparations of adrenal hormones in medium dosages are mainly used. They are administered to the patient until there is a lasting significant improvement in the condition. Then the dosage of the drug begins to be gradually reduced, and after 3-4 weeks it is completely discontinued. In some patients, the condition is so severe that they are unable to take medications by mouth on their own. In these cases, hormones are administered in liquid forms intravenously. Very important are procedures that are aimed at removing immune complexes, which are antibodies associated with antigens, from the body circulating in the blood. For this purpose they use special drugs For intravenous administration, methods of blood purification in the form of hemosorption and plasmapheresis.

Drugs taken orally are also used to help remove toxic substances from the body through the intestines. In order to combat intoxication, the patient’s body should be injected with in various ways at least 2-3 liters of liquid. At the same time, make sure that this entire volume is removed from the body in a timely manner, since when fluid is retained, toxins are not washed out and quite severe complications can develop. It is clear that the full implementation of these measures is only possible in an intensive care unit.

A fairly effective measure is intravenous transfusion of solutions of proteins and human plasma to the patient. Additionally, medications containing calcium, potassium, and antiallergic drugs are prescribed. If the lesions are very large and the patient’s condition is quite severe, then there is always a risk of developing infectious complications, which can be prevented by prescribing antibacterial agents in combination with antifungal drugs. For the purpose of treatment skin rashes they are applied topically various creams containing preparations of adrenal hormones. To prevent infection, various antiseptic solutions are used.

Forecast

As already indicated, 10% of all patients with Stevens-Johnson syndrome die as a result of joining severe complications. In other cases, the prognosis of the disease is quite favorable. Everything is determined by the severity of the disease itself, the presence of certain complications.

Which doctors should you contact if you have Stevens-Johnson Syndrome:

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Other diseases from the group Diseases of the skin and subcutaneous tissue:

Against the background of viral, bacterial, fungal infections, after the administration of medications, some patients with hypersensitivity of the body develop bullous lesions of the skin and mucous membranes. A severe inflammatory process provokes dangerous complications.

With increased sensitization of the body, it is important to know how Stevens-Johnson syndrome develops, what it is, and how to act when identifying signs of a dangerous allergic reaction? Factors provoking development serious illness, symptoms, treatment and prevention methods are described in the article.

Reasons for the development of pathology

An acute allergic reaction develops against the background of the following factors:

• taking or administering medications. A negative response is most often caused by antibiotics (especially penicillins) - more than half of the cases, NSAIDs - up to 25%. The list of potential allergens includes vitamins, sulfonamides, local anesthetics;
• developing cancer;
• penetration of pathogenic microorganisms. The infectious-allergic form of the disease occurs when exposed to viruses, contact with protozoans, fungal infections, and bacterial agents;
• idiopathic form of a dangerous reaction. Unexplained etiology of severe illness accounts for 25 to 50% of cases.

Stevens-Johnson syndrome ICD code - 10 - L51.1 (bullous erythema multimorpha).

First signs and symptoms

Heavy allergic disease belongs to the group of bullous dermatitis with characteristic feature: blisters on mucous membranes and skin. Other symptoms also appear: negative reactions affect the epidermis, internal organs, lips, eyes, and oral cavity.

Patient's condition appearance reminds me of a patient clinical picture after receiving severe burns. The danger of an allergic disease is the high rate of progression of negative manifestations. Danger syndrome is an immediate reaction.

How the disease develops:

• An immediate allergic reaction has an acute onset. The early stage is similar to development viral infection: temperature rises, often up to 39-40 degrees, headache, weakness appears, painful sensations in joints and muscles, heart rate increases;
• then cough, sore throat, vomiting, and diarrhea occur. After 5-6 hours (no later than 24 hours), the oral mucosa becomes covered with large blisters. Quite quickly, the blisters open, erosions form, covered with dried blood, yellowish or grayish-white films. The dangerous process spreads further and affects the lips. For this reason, it is very difficult for patients to drink and eat;
• one of the signs is . Dangerous complication - purulent inflammation with the formation of erosive and ulcerative elements on the cornea and conjunctiva. Eye damage develops;
• Purple blisters are noticeable on the skin. The diameter of the formations is up to 5 cm; bloody or serous zones are visible in the center of large blisters. After opening, erosions appear, then the affected area becomes covered with crusts. The main places for rashes are the perineum, different zones torso;
• half of patients suffering from dangerous syndrome, the area of ​​the genital organs and urinary system becomes inflamed. Vaginitis, cystitis, urethritis, balanoposthitis with scar formation often leads to damage to the urethra;
• the period of rash lasts up to three weeks, the affected areas take a long time to heal - up to one and a half months. Often a dangerous disease is accompanied by complications: renal failure, pneumonia, bleeding from an inflamed bladder, visual impairment, secondary infection, colitis. A massive attack on the body leads to the death of almost 10% of patients.

Effective treatments

The examination is carried out by a therapist, and the patient is necessarily examined by an allergist. It is important to find out what factor provoked the dangerous reaction and what medications should not be given to the victim during therapy. The doctor finds out whether allergic diseases have occurred before and how the body reacted to irritants.

The rapid development of the immune response threatens the patient's life. If the signs described in the “Symptoms” section appear, you should not hesitate to call an ambulance: failure to provide assistance in a timely manner is dangerous for the patient. If Stevens-Johnson syndrome is suspected, the patient is admitted to a hospital, and resuscitation measures are often required.

Main directions of therapy:

• emergency care - to prevent dehydration, as in patients with severe burns. Doctors inject saline and colloid solutions into a vein; if the patient is able to drink, then the liquid is given orally;
• at the doctor's discretion, glucocorticosteroids are administered (intravenously, jet) or pulse therapy early stages allergic reaction. The second option is less toxic to the body, and there are fewer dangerous complications;
• at severe form, active development pathological process a tracheotomy may be needed artificial ventilation lungs. If such reactions occur, the patient is immediately taken to intensive care;
• in the hospital, doctors carry out deintoxication, prevent secondary infection, and exclude repeated contact with the irritant, especially when dosage form allergies;
• required infusion therapy with the introduction of special solutions;
• It helps to reduce the load on the body and prevent the effects of dangerous types of food. It is important to remember that for an allergy sufferer with a severe form of a negative reaction, any amount of inappropriate food can be dangerous;
• prevent intrusion harmful bacteria It helps to place the patient in a room with sterile conditions, like in a burn department;
• eliminate the consequences skin reactions disinfectant and saline solutions, corticosteroid, wound healing, emollient creams and ointments. Good effect during the recovery stage they give hormonal drugs Celestoderm, Elokom, Advantan, Lokoid.

Penicillins and B vitamins are strictly contraindicated: these drugs increase the risk of allergic reactions, provoke increased negative symptoms.

There are also other therapeutic measures and manipulations:

• the addition of a bacterial, fungal, or viral infection requires the prescription of effective combined ointments. The recommended drugs are Belogent, Pimafukort, Triderm;
• antihistamines relieve the sensitivity of histamine receptors and prevent further release of inflammatory mediators. Doctors select antiallergic medications taking into account the patient’s age, condition, and severity of the reaction. Long-term treatment requires the use of classic antihistamines, which quickly relieve allergy symptoms;
• After eating, an inflamed oral cavity must be treated with antiseptics and hydrogen peroxide;
• Elimination of negative symptoms in the eyes is carried out using eye drops and gels. Drugs: Oftagel, Azelastine, Prednisolone;
• in case of organ damage genitourinary system Solcoseryl ointment and antiseptic solutions are applied to the inflamed areas; in case of severe rashes, glucocorticosteroids are applied for topical use;
• at severe pain muscles and joints require analgesics. The doctor selects the medications depending on the severity of the case.

Go to the address and read the information about whether you can be allergic to frost on your face and how to treat the disease.

Stevens-Johnson syndrome in children

Up to 3 years of age, doctors rarely register a dangerous allergic disease. The main age category of patients is men aged 20 to 40 years, women get sick less often.

A severe reaction to irritants is dangerous for a growing organism, weak immunity does not allow babies to fight infection. Symptoms of the disease in children are similar to negative manifestations in adults.

IN early age The main reason for the development of a dangerous disease is the administration or use of antibiotics, more often penicillin. The reaction is lightning fast, the signs are life threatening.

Required immediate intervention doctors, placing the child in a separate box, ensuring sterility, as when treating patients with burn injuries. Conducted complex therapy with the use of glucocorticosteroids, saline solutions, wound healing ointments. It is obligatory to take medications that cleanse the body.

Note:

• After recovery, the patient and loved ones must analyze the situation and remember what irritants led to the negative response of the body. Monitoring your medication intake will help prevent the development of a severe reaction. IN outpatient card doctors write down the medications that caused bullous erythema multiforme;
• patients who have suffered acute allergic reaction, it is prohibited to take medications on your own initiative: inappropriate medications may cause relapse dangerous disease- Stevens-Johnson syndrome. The consequences of a second attack are often more severe than in the first case of allergic pathology: it is important to remember what a negligent attitude towards health can result in.

At hypersensitivity The body develops both mild and acute reactions. One of the most dangerous diseases allergic nature - Stevens-Johnson syndrome. Erosions, sores, blisters, vomiting, high temperature, damage to the mucous membranes and internal organs, deterioration in health - these are not all the symptoms of a serious illness.

If you suspect the development of a serious illness the best way out an ambulance will be called to transport the patient to the hospital. Home methods, folk remedies, self-medication - not suitable methods of therapy: Only qualified doctors can help the patient; in severe cases, resuscitators are indispensable.

Qualified specialist in next video will tell you more about Stevens-Johnson syndrome: