Stevens-Johnson Syndrome
Introduction to Stevens-Johnson Syndrome
Welcome to the Stevens-Johnson Syndrome subsection of the Dermatology for the MSRA course.
This section is designed to provide comprehensive and structured learning materials to help you understand and master the topic of Stevens-Johnson Syndrome for the MSRA.
Resources for Stevens-Johnson Syndrome:
- Stevens-Johnson Syndrome Revision Notes for MSRA: Detailed and concise notes covering causes, symptoms, diagnosis, and treatment based on UK NICE guidelines. Use these notes to get a thorough understanding of the condition.
- Stevens-Johnson Syndrome Flashcards for MSRA: Interactive flashcards to help you retain key facts and concepts related to Stevens-Johnson Syndrome. Perfect for quick revision sessions and reinforcing knowledge.
- Stevens-Johnson Syndrome Accordion Q&A Notes for the MSRA: A question-and-answer style resource designed to enhance active learning and test your understanding. Ideal for quick coverage of weak areas.
- Stevens-Johnson Syndrome Rapid Fire Quiz for MSRA: A fast-paced quiz to evaluate your recall and understanding of Stevens-Johnson Syndrome. Use it to assess your progress and readiness for more advanced material.
We encourage you to use these resources as part of your revision plan, and explore related topics within the Dermatology for the MSRA course.
Key Points about Stevens-Johnson Syndrome:
- Definition: Stevens-Johnson Syndrome (SJS) is a rare but severe mucocutaneous reaction, usually triggered by medications or infections, characterized by widespread skin detachment and mucosal involvement. It is part of a spectrum with toxic epidermal necrolysis (TEN), differentiated by the extent of skin involvement.
- Causes:
- Medications: Most common triggers include sulfonamides, antiepileptics, allopurinol, and NSAIDs.
- Infections: Mycoplasma pneumoniae and herpes simplex virus.
- Idiopathic cases with no known trigger.
- Symptoms:
- Flu-like prodrome with fever, malaise, and sore throat.
- Painful, erythematous macules that rapidly progress to blisters and epidermal detachment.
- Mucosal involvement (oral, ocular, and genital) leading to painful ulcers.
- Widespread skin sloughing in severe cases.
- Diagnosis:
- Clinical examination and history of drug exposure or recent infection.
- Skin biopsy to confirm necrosis and rule out other conditions.
- Classification based on body surface area (BSA) involvement: SJS (<10% BSA), SJS/TEN overlap (10–30% BSA), TEN (>30% BSA).
- Management:
- Immediate discontinuation of the causative agent.
- Supportive care in an intensive care unit or burns unit.
- Fluid replacement, wound care, and pain management.
- High-dose corticosteroids or intravenous immunoglobulin (IVIG) may be considered in some cases.
- Ongoing monitoring for complications such as secondary infections, dehydration, and multiorgan failure.
- Complications:
- Permanent skin pigmentation changes or scarring.
- Ocular complications such as chronic dry eyes or blindness.
- Respiratory issues due to mucosal involvement.
- Mortality is high in severe cases, particularly with TEN.
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