🧑⚕️ FREE MSRA PODCAST – Stevens-Johnson Syndrome (SJS): Emergency Recognition & Management
🔥 Your essential, high-yield crash course on SJS—perfect for the MSRA and real-life practice. Listen up for life-saving revision!
Key Learning Points
📌 Definition & Spectrum
• Stevens-Johnson Syndrome (SJS) is a rare but severe mucocutaneous reaction—most often to medications, sometimes infections
• Marked by blistering rash, widespread skin detachment, and mucosal involvement
• Part of the SJS-TEN spectrum (differentiated by % body surface area involved)
🚩 Causes & Risk Factors
• Drugs: Sulphonamides, anticonvulsants (carbamazepine, lamotrigine), allopurinol, NSAIDs
• Infections: Mycoplasma pneumoniae, herpes simplex, influenza (especially in children)
• Genetic predisposition (HLA alleles), HIV infection, previous SJS, immunosuppression
🩺 Clinical Features
• Prodrome: Fever, malaise, sore throat, then sudden widespread erythematous/purpuric rash
• Blistering and epidermal detachment, positive Nikolsky sign
• Severe, painful mucosal erosions: mouth, eyes, genitals
• Lesions start on trunk, spread to limbs, palms, soles
• May rapidly progress to multi-organ involvement
🧠 Mnemonic: SJS
S: Stop the drug immediately
J: Junctions (mucosal) involved
S: Sloughing of skin
🔬 Diagnosis & Classification
• Clinical diagnosis is key—history of new drug exposure or recent infection
• Biopsy confirms keratinocyte necrosis (for unclear cases or to rule out differentials)
• Classify:
SJS: <10% BSA
SJS/TEN overlap: 10–30% BSA
TEN: >30% BSA
⚡ Differential Diagnoses
• Toxic epidermal necrolysis (TEN)
• Erythema multiforme
• Bullous pemphigoid, pemphigus vulgaris
• Staphylococcal scalded skin syndrome (SSSS)
• Drug-induced rashes
🏥 Investigations
• FBC, U&Es, LFTs, CRP/ESR, coagulation, cultures
• Skin swabs, serology if infection suspected
• SCORTEN score predicts severity/mortality
💊 Management (UK/NICE)
• Immediate withdrawal of offending drug—non-negotiable
• Admit to ITU/burns unit for specialist supportive care
• IV fluids, wound care, analgesia, nutritional and eye support
• Monitor for sepsis, multi-organ failure
• Steroids/IVIG: Specialist advice only—controversial role
🌟 Prognosis & Complications
• Mortality: SJS 5–10%, TEN >30%
• Long-term: Skin scarring, pigment changes, strictures, chronic eye disease, blindness
• Acute: Sepsis, dehydration, respiratory failure, DIC, multi-organ failure
📎 More MSRA Revision for Stevens-Johnson Syndrome:
📝 Revision Notes: https://www.passthemsra.com/topic/stevens-johnson-syndrome-revision-notes/
💬 Flashcards: https://www.passthemsra.com/topic/stevens-johnson-syndrome-flashcards/
🧠 Accordion Q&A: https://www.passthemsra.com/topic/stevens-johnson-syndrome-accordion-qa-notes/
🚀 Rapid Quiz: https://www.passthemsra.com/topic/stevens-johnson-syndrome-rapid-quiz/
🧪 Full Quiz: https://www.passthemsra.com/quizzes/stevens-johnson-syndrome/
🎓 Dermatology Course: https://www.passthemsra.com/courses/dermatology-for-the-msra/
🌐 For more free & premium revision resources:
https://www.passthemsra.com
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