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How is Stevens Johnson Syndrome diagnosed?

See how Stevens Johnson Syndrome is diagnosed. Which specialists are essential to meet, what tests are needed and other useful information for the diagnosis of Stevens Johnson Syndrome

Stevens Johnson Syndrome diagnosis

Diagnosis of Stevens Johnson Syndrome


Stevens Johnson Syndrome (SJS) is a rare but severe disorder that affects the skin and mucous membranes. It is important to diagnose SJS promptly to initiate appropriate treatment and prevent complications. The diagnosis of SJS involves a combination of clinical evaluation, medical history assessment, and laboratory tests.



Clinical Evaluation


The first step in diagnosing SJS is a thorough clinical evaluation by a healthcare professional. The doctor will examine the patient's skin and mucous membranes for characteristic signs and symptoms. SJS typically begins with flu-like symptoms such as fever, cough, and body aches, followed by the development of a painful rash. The rash often starts on the face and trunk and rapidly spreads to other parts of the body. It may involve the mucous membranes of the eyes, mouth, and genitals, leading to redness, swelling, and blistering.


Key clinical features that aid in the diagnosis of SJS include:



  • Nikolsky's sign: Gentle rubbing of the skin may cause the outer layer to separate, indicating a positive Nikolsky's sign, which is a characteristic finding in SJS.

  • Mucosal involvement: The presence of mucosal involvement, especially in the eyes and mouth, is a significant indicator of SJS.

  • Target lesions: The appearance of target-like lesions on the skin, with a dark center surrounded by a pale ring and a red outer ring, is a typical feature of SJS.



Medical History Assessment


A detailed medical history assessment is crucial in diagnosing SJS. The doctor will inquire about any recent medication use, as certain drugs are known to be associated with SJS. Common culprits include antibiotics (such as sulfonamides and penicillins), anticonvulsants (such as phenytoin and carbamazepine), and nonsteroidal anti-inflammatory drugs (such as ibuprofen and naproxen). It is important to provide accurate information about any medications taken prior to the onset of symptoms.


Other factors that may be considered during the medical history assessment include:



  • Recent infections: SJS can sometimes be triggered by a preceding infection, such as herpes or pneumonia.

  • Past episodes: A history of previous episodes of SJS or a related condition called toxic epidermal necrolysis (TEN) may increase the likelihood of a diagnosis.

  • Family history: Although rare, there may be a genetic predisposition to SJS in some cases.



Laboratory Tests


Laboratory tests are essential to confirm the diagnosis of SJS and rule out other possible causes. These tests may include:



  • Skin biopsy: A small sample of affected skin may be taken for microscopic examination. This can help identify characteristic changes in the skin layers that are indicative of SJS.

  • Blood tests: Complete blood count (CBC) and liver function tests (LFTs) are commonly performed to assess the overall health status and detect any abnormalities.

  • Immunological tests: Certain immunological tests, such as enzyme-linked immunosorbent assay (ELISA), may be conducted to detect specific antibodies or markers associated with SJS.



It is important to note that the diagnosis of SJS can be challenging due to its similarity to other skin conditions. Therefore, a multidisciplinary approach involving dermatologists, ophthalmologists, and other specialists may be necessary to confirm the diagnosis.



Conclusion


Diagnosing Stevens Johnson Syndrome requires a combination of clinical evaluation, medical history assessment, and laboratory tests. The doctor will carefully examine the patient's skin and mucous membranes for characteristic signs and symptoms, while also considering the medical history, recent medication use, and any previous episodes of SJS or related conditions. Laboratory tests, such as skin biopsy and blood tests, are performed to confirm the diagnosis and rule out other possible causes. Prompt and accurate diagnosis is crucial to initiate appropriate treatment and prevent complications associated with SJS.


Diseasemaps
4 answers
Bloods and biopsies

Posted Feb 24, 2017 by Sophie 1150
Translated from spanish Improve translation
I think that you should hire a doctor

Posted Oct 4, 2017 by Yolika 2000
Translated from spanish Improve translation
The disease is unknown, making it difficult to opportune diagnosis. The first 4 days I was diagnosed with poisoning and gave me avapena, but I was getting worse. That is why it is important to be informed and know the symptoms so that you can be treated before the disease progresses and is fatal or irreversible damage.

Posted Oct 16, 2017 by Karen 3550

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Stories of Stevens Johnson Syndrome

STEVENS JOHNSON SYNDROME STORIES
Stevens Johnson Syndrome stories
I got SJS/TENS from taking lamictal. I was in the ICU burn unit at Grady hospital in Atlanta for 7 weeks. 5 of those I was in a medically induced coma. I lost 90% of my skin, all my hair and fingernails. My skin has come back mostly without scars. Ho...
Stevens Johnson Syndrome stories
I had gone to one hospital with a severe rash, I met a physician who know exactly what this was. I was transfered to the Burn Unit, where I received an active coat treatment and my body wrapped in guaze. With IV medication and constant lotion applied...
Stevens Johnson Syndrome stories
I WAS IN A CONSTRUCTION ACCIDENT AND BLEW MY KNEES OUT WHERE THEY WERE BONE ON BONE I RECEIVED 3 INJECTIONS OF EUEFLEUX SHOTS AND AFTER THE SECOND SHOT I BROKE OUT WITH BLISTERS AND HIVES NOBODY KNEW WHAT THEY WERE I WAS TREATED FOR THREE AND A HALF ...
Stevens Johnson Syndrome stories
Callum had SJS twice in 2013 at the age of 7. We still have no definite trigger 
Stevens Johnson Syndrome stories
My granddaughter had TEN a year ago. She had a rash that was diagnosed as Scarlett fever. After 24hours she wasd admitted to our local emergency ward. She was diagnosed with SJS within a few hours and transferred to Evelina London. The care she had t...

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