Home
About Us
Is Your Child Sick?
Our Services
New Patients
Forms and Policies
Medical Resources
   Medical Conditions
      Abdominal Pain, Recurrent
      Acne
      Acute Lymphoblastic Leukemia
      Acute Otitis Media
      Acute Strep Throat
      Addison
      AIDS/HIV
      Anxiety
      Appendicitis
      Atopic Dermatitis (Eczema)
      Attention-Deficit Hyperactivity Disorder
      Attention-Deficit Hyperactivity Disorder (ADHD)
      Breast Enlargement, Premature
      Breath-Holding Spells
      Bronchiolitis
      Care of the Premature Infant
      Celiac Disease
      Chickenpox
      Chickenpox Immunization
      Coarctation of the Aorta
      Congenital Hip Dysplasia
      Coxsackie A16
      Cyclic Vomiting Syndrome (CVS)
      Depression
      Developmental Dysplasia of the Hip
      Diabetic Mother, Infant of
      Ear Infection
      Eating Disorders
      Eczema
      Enlarged Lymph Nodes
      Erythema Multiforme
      Eye Problems Related to Headache
      Febrile Seizure
      Fetal Alcohol Syndrome
      Fifth Disease (Erythema Infectiosum)
      Flu
      Food Born Illnesses
      Fragile X Syndrome
      Gastroenteritis, Viral
      Gastroesophageal Reflux
      Giardiasis
      Hand Foot and Mouth
      Head Lice
      Headache Related to Eye Problems
      Hemangioma
      Hepatitis A
      Hepatitis A Immunization
      Hepatitis B
      Hepatitis B Immunization
      Hepatitis C
      Hib Immunization
      High Blood Pressure
      HIV/AIDS
      Hyperactivity
      Hypertension
      Hypothyroidism
      Immunization
      Infant of a Diabetic Mother
      Infectious Mononucleosis
      Influenza Immunization
      Influenza-Seasonal
      Kawasaki Syndrome
      Language Development in Young Children
      Lead Poisoning
      Leukemia
      Lung Hypoplasia
      Lyme Disease
      Lymphadenopathy
      Measles
      Mental Health
      MMR Immunization
      Mumps
      Obesity in Childhood
      Otitis Media, Acute
      Pneumococcal Conjugate Immunization
      Polio Immunization
      Premature Thelarche
      Prematurity
      Prematurity, Retinopathy of
      Pulmonary Hypertension
      Pulmonary Hypertension (PPH & SPH)
      Retinopathy of Prematurity
      Rheumatic Fever, Acute
      Ringworm (Tinea)
      Roseola
      Rotavirus
      Rubella (German Measles)
      Scabies
      Separation Anxiety
      Sinusitis
      Smoking
      Speech Development in Young Children
      Stevens-Johnson Syndrome
      Strep Throat-Acute
      Strep Throat-Recurrent
      Stuttering and the Young Child
      Swine Flu
      Swine Flu (H1N1) FAQ
      Swine Flu (H1N1) Vaccine
      Swollen Glands
      Tattoos
      Tear Duct, Blocked
      Tetralogy of Fallot
      Thyroid Problems
      Tinea (ringworm infection)
      Toxic Shock Syndrome
      Toxoplasmosis
      Turner Syndrome
      Underdeveloped Lungs
      Urinary Tract Infection
      Varicella or Chickenpox
      Varivax Immunization
      Vesicoureteral Reflux
      Wheezing-Infant
      Wilson Disease
   What's Going Around?
   Medical Library
Contact Us

Practice News

Currently, there are no announcements.

Is Your Child Sick?TM

Stevens-Johnson Syndrome

by William L. Weston, M.D.
Professor of Dermatology
University of Colorado Health Sciences Center

What is SJS?

SJS, or Stevens-Johnson Syndrome, is an abrupt, severe injury to the mouth, eyes, and skin, where large sheets of mucosa or skin are destroyed and then shed. The occurrence of SJS is uncommon.

top

What causes SJS?

For most individuals, SJS is the result of a drug reaction. Sulfa drugs, seizure drugs, and analgesics (pain relievers) are the most common medicines to cause SJS; however, a large number of drugs can cause it. In a few individuals, infections, such as pneumonias caused by Mycoplasma, may cause SJS.

top

Who gets SJS?

SJS mostly occurs in toddlers and in young children.

top

How does a drug reaction cause disease?

The skin of the person who has a reaction to a drug may not correctly eliminate it. The reaction most likely occurs because of a genetic mutation in one of the enzymes that is responsible for eliminating drugs from the body. The drug builds up in the lining of the skin, mouth, and eyes, and severely damages the tissue. It is similar to a burn, but the damage occurs from the inside out. Internal organs also may be involved.

top

What are the common findings?

The initial signs of SJS are bloody crusts on the lips, a sore mouth that has a foul smell, and purple-red tender spots on the skin. Drinking and eating are difficult, and light is painful to the eyes. Large areas of tissue death occur, and large blisters may form, followed by a loss of large sheets of the skin or the mouth. The linings of the eyes have pus drainage, and they may heal with scarring so that the eyelids do not move normally. The cornea also may erode. Fingernails may be shed, and a loss of skin color may occur. Severe stomach problems may occur in some individuals, and diarrhea and kidney or liver damage may result. The internal lining of the airway may slough off, blocking breathing.

top

How is SJS diagnosed?

Most physicians diagnose SJS from the involvement of the mouth and the eyes, plus the appearance of skin lesions. Sometimes, a skin biopsy may be needed to distinguish SJS from other conditions, such as pemphigus, which is another blistering condition.

top

How is SJS treated?

There is not a specific treatment for SJS at the time of an attack. Treatment for SJS consists of replacing fluids, calories, and salts, and then treating the skin as if it was a burn. If a drug is suspected of causing SJS, it should be stopped.

SJS is a severe, life-threatening condition, and the best treatment occurs when the child is admitted to a hospital with a pediatric burn unit or a pediatric intensive care unit.

top

What are the complications?

The complications of SJS are similar to a severe burn. The following complications may occur: infection through the open skin, dehydration, salt disturbances, fever, scarring, fingernail loss, loss of skin color, breathing problems, pneumonia, kidney failure, liver problems, and death.

top

How can SJS be prevented?

SJS may be prevented by avoiding those drugs that have caused reactions in the past, and by not taking those drugs that are more likely to cause SJS. However, for most individuals, SJS appears unexpectedly and cannot be prevented.

top

What research is being done?

Researchers are currently examining treatments that block the cell death pathways. Potential genetic mutations also are being examined, which may help in developing tests that can predict who will get a severe reaction to a particular class of drugs.

top

About the Author

Dr. Weston is a Professor of Pediatrics and Dermatology at the University of Colorado Health Sciences Center and Chair of the Department of Dermatology. His scientific and clinical interests include Cutaneous immunology, Cutaneous virology, and Pediatric Dermatology.

Dr. Weston is the primary author of the Color Textbook of Pediatric Dermatology (Weston, Lane, Morelli; Mosby, Inc.) which is used by clinicians worldwide and is published in 4 languages.

He created the Genetic Skin Disorders clinic at the University of Colorado in 1998.

Copyright 2012 William L. Weston, M.D., All Rights Reserved