Stevens Johnson Syndrome

Home » Inflammatory Dermatoses » Stevens Johnson Syndrome
Inflammatory Dermatoses No Comments
  • Check Drug History
  • Stop NSAIDs – including Difflam mouthwash (Benzydamine)
  • Stop any other offending drugs
  • 2 x 4mm punch biopsy – one for H+E (lesional in formalin) and one for IMF (perilesional in Michel’s transport media)
  • Eyes – Urgent Ophthalmology review – need to prevent pseudomembrane formation
  • Mouth
    • ENT/Oral Medicine review.
    • Betnesol 500mcg dissolved in 20ml of water and rinsed 3 x daily.
      • Alternative – Prednisolone 5mg soluble in similar manner
      • Nystatin 1ml QDS orally
    • Nutritional support – fortisips / protein enriched
    • Fucidin ointment to lips qds topically
  • Pain relief
    • Consider oramorph
  • Respiratory
    • Chest x-ray
  • GI
  • GU
    • Gynae review to exclude vulval involvement
  • Skin
    • Check for skin fragility – Nikolsky sign
    • Calculate Body Surface Area Involvement
    • SCORTEN score
    • Dermovate ointment BD
    • Consider IVIG