A fever and a Rash
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Stevens-Johnson Syndrome presents a critical dermatological emergency characterized by mucosal lesions and diffuse rash with high mortality if untreated. Recognizing this condition requires understanding its presentation, pathophysiology, and immediate management strategies to improve patient outcomes.
• Case presentation of 20-year-old female with fever, mucosal lesions, and diffuse rash
• Mucosal involvement is the key diagnostic feature of Stevens-Johnson syndrome
• Common triggers include sulfa drugs, anti-epileptics, NSAIDs, and infections like mycoplasma
• Positive Nikolsky sign where skin cleaves and sloughs off when pressed
• SJS affects less than 10% of body surface area while TEN involves more than 30%
• Treatment includes supportive care, fluids, nutrition, and controversial steroids
• IVIG, plasmapheresis, and TNF blockers may be beneficial treatment options
• Approach treatment similar to severe burns with non-adherent dressings
• Secondary infections may require antimicrobials, but not as initial treatment
• Eye involvement requires artificial tears and careful monitoring
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