HughS. Stannus

STEVENS-JOHNSON SYNDROME

Stevens-Johnson syndrome (SJS) is an immune-complex-mediated hypersensitivity disorder. It ranges from mild skin and mucous membrane lesions to a severe, sometimes fatal systemic illness: toxic epidermal necrolysis (TEN). SJS, SJS/TEN overlap and TEN form a spectrum of severe cutaneous adverse reactions (SCAR) that can be differentiated by the degree of skin and mucous membrane involvement. They are mainly, but not always, caused by drugs. Erythema multiforme (EM) was previously considered to be a milder form of SJS without mucosal involvement; however, the clinical classification defined by Bastuji-Garin in 1993 separates EM as a clinically and aetiologically distinct disorder and has now been accepted by consensus. [1] Erythema multiforme is usually mild (EM minor), with only a few spots, which resolve quickly. The much less common but much more severe type (EM major) can be lifethreatening with involvement of the mucous membranes in the mouth, the genital area and on the conjunctiva.