Stevens-Johnson Syndrome (SJS) is a rare but serious hypersensitivity reaction that affects the skin, mucous membranes, and eyes. SJS usually starts with flu-like symptoms, such as fever, sore throat, and fatigue. A painful rash then appears and spreads quickly. In severe cases, it can cause the top layer of skin to die and peel off in sheets.
A challenging part of diagnosing the cause of SJS is that it's often triggered by medications, including over-the-counter medications. If you suspect you’re having an adverse reaction to certain prescribed or over-the-counter drugs, it’s best to stop the suspect drug and see a doctor for immediate medical attention.
Here’s what you need to know about diagnosing this serious condition.
Diagnosing Stevens-Johnson Syndrome
To diagnose SJS, doctors piece together the puzzle based on symptoms, medical history, and the ruling out of other conditions.
Physical Exam and Medical History Review
SJS often causes a distinctive pattern — red or purplish spots that spread and blister. The eyes, mouth, and genitals are often affected, too. Doctors look for the involvement of at least two mucous membrane sites.
But many conditions can cause rashes, so doctors ask about recent medication use to narrow the search. If the symptoms started within a few days or weeks of taking a new drug, then that can be a red flag for SJS.
Skin Biopsy
Your healthcare provider then takes a sample from your skin for a biopsy. This laboratory test checks for patterns in your cells associated with Stevens-Johnson Syndrome and rules out other conditions.
Organ Function Tests
In severe cases, your healthcare provider can run tests to determine your liver function, renal function, and complete blood count. They can also take images of your lungs and perform a cardiac function test.
The SCORTEN Scale for SJS
Certain doctors also use a scoring system called SCORTEN to assess the severity of SJS. The test accounts for factors such as:
- Age above 40 years
- Malignancy
- Heart rate of over 120 beats per minute
- Initial surface area of epidermal detachment greater than 10%
- Serum urea level over 10 mmol/L
- Serum glucose level over 14 mmol/L
- Serum bicarbonate level of under 20 mmol/L
If met, each parameter gets a score of 1, and your doctor adds the total.
Higher scores mean higher mortality risks, including:
- 0 to 2 suggests a 3.2% mortality
- 2 suggests 12.1% mortality
- 3 predicts 35.3% mortality
- 4 predicts 58.3% mortality
- 5 predicts >90% mortality
Understanding the diagnosis process can help you advocate for yourself or a loved one if symptoms arise.
Possible SJS Treatment Options
If SJS is suspected, doctors will likely stop any suspect non-essential medications. Treatment focuses on supportive care like managing pain, preventing infection, and keeping the body in balance as it heals. They may transfer you to a burn unit or intensive care for close monitoring, and recovery can take weeks or months.
How a Stevens-Johnson Syndrome Attorney Can Help You
A confirmed diagnosis gives you possible grounds to file an SJS lawsuit against the pharmaceutical company manufacturing the drug. An experienced Stevens-Johnson Syndrome attorney can help you determine whether you have a viable case.
An SJS attorney helps investigate which drug may have caused the reaction and whether proper warnings were provided. They can also collect and preserve evidence for a pharmaceutical product liability lawsuit to pursue your compensation.
FAQ
How Long Does SJS Take to Develop?
The challenge is catching SJS early. In the first few days, it can look like a mild drug reaction or viral infection. By the time the hallmark symptoms appear, it may have already progressed significantly.
What’s the Difference Between SJS and TEN?
You’re diagnosed with SJS if the affected skin covers less than 10% of your body. Toxic epidermal necrolysis (TEN) occurs when over 30% of your body's surface area is affected. Total body surface area (TBSA) coverage of 10-30% is called SJS-TEN overlap.
What Conditions Can Be Mistaken for SJS?
Stevens-Johnson Syndrome can be initially mistaken for acute generalized exanthematous pustulosis (AGEP) and drug hypersensitivity syndrome (DHS), which are also severe cutaneous adverse reactions to drugs. SJS could also be confused with erythema multiforme early in the progression of the reaction. Further medical investigations aid in accurate diagnosis.
Facing a Stevens-Johnson Syndrome Diagnosis?
An SJS diagnosis for you or your loved one can be overwhelming. The skilled team at Dunn Sheehan has advocated for people with SJS lawsuits across the nation, and we are dedicated to holding pharmaceutical companies responsible for the harm caused by their drugs. Reach out for a consultation with us today.