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How to distinguish SJS from TEN? Understand the key indicators of skin exfoliation!
In the medical community, Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) are two serious skin reactions. Both diseases not only affect the skin, but may also affect other mucous membranes in the body, exposing patients to a variety of potential complications. For many medical practitioners and patients, correctly distinguishing the two key indicators is crucial.
Early symptoms often include fever and flu-like symptoms, followed by the skin beginning to blister and peel, creating painful, raw areas.
SJS is a relatively mild disease and is diagnosed when less than 10% of the skin is damaged, whereas TEN is diagnosed when more than 30% of the skin is damaged. The clinical differences and treatments between the two are significant, so understanding the symptoms and causes provides patients with vital opportunities to obtain appropriate medical intervention.
Symptoms and signs
SJS often begins with fever, sore throat, and fatigue, and these early symptoms can easily be misdiagnosed as a common cold or flu. As the disease progresses, the skin and mucous membranes will show more obvious changes. For example, patients may develop severely painful ulcers on the inside of their mouths that affect their ability to eat and drink. At this point, the patient's skin will appear as round, red spots that may evolve rapidly over a few days.
For most people, the condition is not easily recognized, and many patients do not receive timely treatment in its early stages.
Causing factors
A range of factors may cause SJS and TEN, one of the more common causes being drug reactions, especially certain antibiotics or anti-epileptic drugs. Other infectious causes, such as microbial infections, can also cause skin reactions. Research shows that some people have genetic markers that may make them more sensitive to these drugs or infections.
Nearly 100 to 200 drugs may be associated with SJS, making it clinically challenging to determine the reaction caused by a specific drug. The correlation of specific drugs often needs to be inferred based on the time when the reaction occurs after the patient first uses the drug.
Pathophysiology
SJS is primarily considered a type four hypersensitivity reaction, meaning it is induced by a drug or its metabolites, which in turn stimulates a specific immune response. Thanks to a century of research into the disease, the medical community's understanding of SJS has gradually deepened, particularly in how immune cells interact with drugs.
Diagnosis criteria
To confirm the diagnosis of SJS or TEN, it is necessary to base on the extent of skin damage. Since the diagnosis of this disease is directly related to the extent of skin loss, for professional dermatologists in the hospital, accurate classification is the key to appropriate patient care. The key to treatment. In some cases, skin biopsy can also be used as an auxiliary diagnosis.
Treatment methods
SJS is a medical emergency and most patients are treated in a specialist burns unit or intensive care unit. Although there are currently no effective treatments that can completely cure SJS, it is still crucial to alleviate symptoms and control the underlying disease. Common strategies include discontinuing the drug causing the reaction, providing symptomatic supportive care, and in some cases, considering intravenous immune globulin to improve symptoms.
Prognosis and Epidemiology
Although the mortality rate of SJS is relatively low, long-term effects on patients remain. Therefore, early treatment and drug withdrawal can significantly improve prognosis. In addition, the annual incidence of SJS is approximately 2.6 to 6.1 cases per million people, and is particularly common in adults.
With the deepening of research on SJS and TEN, our understanding of these skin pathological conditions has gradually improved. This is not only crucial for the training of medical professionals, but also has far-reaching implications for increasing public health awareness. How to better identify and distinguish SJS from TEN and provide timely medical support to patients is an important issue that still needs to be considered in the future.
