Stevens Johnson syndrome

Stevens-Johnson syndrome (SJS) is an acute inflammatory skin condition.

Terminology

SJS is on a spectrum of disease with toxic epidermal necrolysis syndrome (TENS) at the more severe end. Terminology depends on how much of the body surface area is involved :

• SJS: <10%
• SJS-TENS overlap: 10-30%
• TENS: >30%

Epidemiology

SJS is very rare, with an incidence of 1-2 per 1,000,000 .

Clinical presentation

The diagnosis of Steven Johnson syndrome is made clinically, few clinical features include:

• fever
• sore throat
• runny nose
• myalgia
• painful rash with mucosal surface involvement

Pathology

Stevens-Johnson syndrome is thought to be triggered by preceding viral infection or more commonly medication use (e.g. NSAIDs, antibiotics, anticonvulsants). Skin and mucosal surface (e.g. gastrointestinal, genital, conjunctival) with blistering and shedding are characteristic .

Differential diagnosis

Differentials of Steven Johnson syndrome include:

• drug hypersensitivity reactions
• staphylococcal scalded skin syndrome
• erythema multiforme