Steven Johnson Sindrome
Lately the medical world was shocked by news related to allegations of widespread malpractice by one of the doctors who lead a young girl suffered damage to the entire face is alleged to be caused by drug allergy, which is given by the doctor to the girl. Maybe you already know what the name of the disease? Yes! Steven Johnson Syndrome name. A pretty cool name for a disease term.
Actually what Steven Johnson syndrome disease that?
What causes it? Obatkah? Viruskah? Bakterikah? Or other?
Then, what are the symptoms of the disease and why it happen?
So follow these simple writing. InsyaALLOH, think you would want to know a little relieved, and hopefully all your questions will be answered after reading the information below.
What is Steven Johnson Syndrome?
Steven Johnson syndrome is a syndrome (a collection of symptoms) is on the skin, mucous membranes in the orifice (the mouth / hole) and subject to general conditions which vary from mild to severe. The disorder can be erythema (redness of the skin due to dilation of blood vessels), vesicle / bull (bubble on the skin containing fluid) and can be accompanied with purpura (bleeding spots on the skin / mucous membranes).
In Dorland medical dictionary is defined as a fatal form of erythema multiforme (a lot of redness / overall) arising with prodormal (initial symptoms) such as the flu, characterized by the existence of systemic lesions (systemic damage) and severe mucocutaneous.
Steven Johnson’s syndrome as a disease also called erythema multiforme mayor.
The incidence of this disease is actually very rare, accounting for only about 2-3% per million population in Europe and the United States. More often suffered by people in adulthood than children.
From various refrensi mentioned, that the exact cause is unknown. But there are trigger factors that cause this disease.
The main causes of drug allergy yajni with the presentation of more than 50%. Most common drug allergy is a group of analgesics (pain relievers), antipyretics (fever-lowering) of approximately 45%, approximately 20% of carbamazepine group and the rest is the type of herbs. Kinds of drugs that have been the cause of the penicillin, barbiturate, amiksisilin, cotrimoxazole, and addictive sefriakson (pacifier).
Other factors that may cause namely:
– Infections such as viruses, fungi, bacteria and parasites.
– Physical factors such as x-ray, sunlight and weather
– Collagen vascular disease (blood vessels, collagen fibers)
– Neoplasms (malignant)
– Kontaktan (only a small part)
The factors influencing the incidence of this disease is the season / climates where cold weather is more influential, and also the physical environment such as x-ray, the cold weather is also the availability of sunlight.
Why Can Happen?
This disease generally occurs because of the hypersensitive reaction of our immune system. Where is the body’s immune system is too sensitive will trigger a hypersensitivity reaction type II body (based on the classification of Coomb and Gel). The next, due to this reaction, the body will react with the appearance of initial symptoms. The initial goal of this hipersensitifitas reaction is a destructive form of skin keratinocytes (the destruction of keratin layers of skin)
Any clinical symptoms?
Clinical symptoms that arise can vary from mild to severe. In patients with severe clinical symptoms generally experience a decrease of consciousness to coma. Travel disease is usually acute (fast) with symptoms of high fever prodormalseperti, malese (weakness), headache, cough, runny nose and sore throat. These symptoms can usually be experienced by up to two weeks.
Ie typical clinical symptoms of the Triassic kalainan (3 abnormalities), namely,
1. Skin disorders
Abnormalities of the skin such as: erythema, vesicles, purpura even bull. Abnormalities usually bersigat generalized (penyeluruh). The nature of the ring-shaped erythema (tenggahnya darker) are usually purple.
2. Mucous membrane disorders in the orifice
Mucous membrane disorder is most often in the mucosa (thin film) mouth (100%), then in the genitals (50%) whereas in the nostrils or rectum rarely (8% and 5%). This disorder can be a vesicle or a bull that was fast break that resulted in erosion (superficial skin kerusakn) and excoriation (abrasion / damage in the skin) and black crusting.
3. Abnormalities of the Eye
Kelianan on the eyes is 80% among all cases. Where is the most common is conjunctivitis (inflammation of the conjunctiva)
Complications from the disease is Steven Johnson Syndrome bronchopneumonia (pneumonia and bronchial inflammation), which is about 16%. Another complication that is blood or fluid loss, electrolyte balance disorders and shock. In the eyes of blindness can occur.
How is the treatment?
The first step in the distancing factor of the cause / originators. If the suspect is a drug, then stop the drug consumption.
Generally penangannya ie restore body fluid and electrolyte balance of patients with infusion fluids because patients generally dehydrated. If the patient into a coma, then the emergency action must be done by balancing the oxygen must be maintained.
Special treatment in the form of systemic treatment with the drug administration groups such as high-dose corticosteroid drug prednisone, and dexamethasone. Topical treatment (outside / to the skin) that is for the bull and the vesicle that breaks were given 2% salicyl powder, wet abnormalities that are compressed with salicyl acid 1%, abnormalities of the mouth are compressed boric acid 3% and conjunctivitis (conjunctival inflammation) were given eye ointment containing corticosteroids or antibiotics.
hopefully a little information could be useful for all readers ..
* Refrensi: Dorland_EGC medical dictionary, medical dictionary _penerbitdjambatan, dermatology kelamin_FK UI, quintessence kulit_EGC disease, pathophysiology vol 2_EGC