Stevens-Johnson syndrome - this is an extremely serious disease threatening that relate to the subspecies allergic effects, since most of it is thanks to them and to developing the disease.This anomaly is quite a shock to the body as a result of manifestation of Stevens-Johnson syndrome in patients affected certain, a large percentage of the skin.
skin carries a significant barrier and protective function, and is also involved in maintaining the balance of the immune system.If you violate the integrity of the cover and partially necrotic lesions, open the gate to enter the body of numerous infections.Thus, when a state of shock, Stevens-Johnson syndrome complicated by the massive infection in the body.By the way, an infectious complication of Stevens-Johnson syndrome, and often becomes the cause of death in patients with this anomaly.
Stevens-Johnson syndrome causes
most often Stevens-Johnson syndrome is caused by medicinal substances.The number of such cases
main drugs - agents of Stevens-Johnson syndrome is, of course, antibiotics: antibiotics and sulfa antibiotics cephalosporin series.Also, Stevens-Johnson syndrome causes excessive use of ointments, which contains diclofenac sodium.Besides the same effect it has several drugs carbamazepine and antibiotics - ampicillin.
is therefore essential to assigning therapy above drugs to take into account the possible sensitivity to them the body and assign well-defined dose, did not abuse their number.
Besides antibiotics, Stevens-Johnson syndrome can cause rows and special anti-epileptic drugs.Some sedatives can also be put in a number of drugs - provocateurs Stevens-Johnson syndrome.
Interestingly, some patients with Stevens-Johnson syndrome may occur without receiving the above-described drugs.A very small percentage of patients with this syndrome is caused by invasion of bacteria, food allergens, pathogens ingested chemicals.Stevens-Johnson syndrome may develop even after vaccination, as a result of the enhanced allergic response of the organism to new and foreign substance to it - antibodies.
allergic cause of playing a key role, thanks to which there is Stevens-Johnson syndrome in children.Like most serious diseases for a small child, this syndrome is very painful.Infants with the syndrome of Stevens-Johnson look like "scalded with boiling water" - so terrible and large-scale skin necrosis in this syndrome in children.
main pathogenic causes symptoms of Stevens-Johnson syndrome are unknown until now.We only know that in the body increases dramatically allergic activity.Activated T lymphocytes that have cytotoxic abilities: these cells are literally larded active substances that can destroy the foreign cells.But the thing is that when Stevens-Johnson syndrome, all aggressive activity aimed at their same structures of the body, namely the skin.These toxic components lymphocytes attacking skin cells - keratocytes.Keratinocytes, under the influence of toxic substances to them are destroyed, and a corona effect at the Stevens-Johnson syndrome: skin and literally advocates moving away from its foundation.
should be noted that Stevens-Johnson syndrome is developing very quickly.Rapidity of its display provides certain hypersensitivity reactions of the body, which trigger the appearance of this anomaly.
way than variations Stevens-Johnson syndrome defined triggering factor, there are those where the cause of the syndrome do not start the install fails.Such forms are usually distinguished by their higher rate of occurrence and heavier lesions.
Stevens-Johnson syndrome symptoms
Interestingly, starting from the time of exposure to the causes and the full development of all signs of Stevens-Johnson syndrome can pass as one day and several weeks.All will depend directly on the level of reactivity of the human immune system: more than "spur" state it is, the faster will Stevens-Johnson syndrome.
Symptoms of the syndrome of Stevens-Johnson has the crown, the main display and additional features.
main manifestations, of course, are skin lesions.The skin is subject to certain localized lesions - bullae or blisters.Their main feature is that if you touch them with any object, the skin will immediately start to flake off.But these bubbles appear not at once.First, in some areas of the skin will itch and rash, which will both spots, and towering elements-papules.This rash is called morbilliform, because it is similar to that in the manifestation of measles.
then this rash with blisters gradually turns sluggish tumble into the lid.The skin near and these bubbles can move away whole layers, as in severe burns.Under descended found red skin surface that can get wet.
first elements of skin lesions in the syndrome of Stevens-Johnson appear on the face and extremities.A few days later they spread and merge.But, and this is an important diagnostic sign - hardly affected hairy areas of the head and hands with the soles.The strongest manifestation of Stevens-Johnson syndrome will be exactly on the extremities and trunk.
skin lesions at the Stevens-Johnson syndrome is extremely large.They can mimic the painting, as if struck by a skin burn at least 2nd degree.The most severely affected those areas of the skin that are exposed to pressure and friction wear.
But if time and correctly prescribe treatment, the affected areas are restored.Their complete healing will take about 3 weeks.Here again it should be remembered that the areas exposed to pressure and covers portions of the orifices will heal longer.
second typical localization of lesions in Stevens-Johnson syndrome are slimy.The majority of patients on the lips there are multiple painful erosion and redness (erythema).Also affected mucous membranes of the external genitalia and the area around the anus.
must also be said that the third "crown" a sign of Stevens-Johnson syndrome is a pain.Pain syndrome is so pronounced that even in the early stages of the syndrome patients experience severe pain even when light pressure is applied to the unaffected skin, bordering on defeat.
Stevens-Johnson syndrome at its most severe stages can cause a number of complications.First - this is, of course, the accession of infectious agents.Damaged skin can no longer protect your body, and therefore, it is extremely at ease are various microbes.
second complication of Stevens-Johnson syndrome are severe eye damage.Maybe fusion conjunctiva century eyeball, corneal blood vessels can grow or appear affected volvulus century.
third complication is the appearance of skin complications.In healing the skin may occur permanent scars, and benign.And if the disease process localized near the nail, then afterwards they may lose the ability to grow or even fall.
Stevens-Johnson syndrome diagnosis
main feature of Stevens-Johnson syndrome is a syndrome Nikolsky.He says that if you touch the skin near pathological bull (bubble), it is easy to begin to flake.
addition, it is important to establish a link between the adoption of a specific person starting substance and the development of the disease.It is also important to take into account the localization of lesions - the syndrome of Stevens-Johnson will be affected only the skin of the face and extremities.
can do a biopsy of the skin area and to see in it the characteristic changes: necrosis of epidermal cells, the emergence of subcutaneous infiltration of a large bull, and the affected area of skin lymphocytes.
Besides bacteriological pathogens spend the selection of necrotic discharge.Most often it has been held in order to find the sensitivity of bacteria to certain medications and prescribe the correct antibiotic.
In addition to these methods, common to all patients will analyze the blood.It will be present signs of inflammation, and sometimes increase the amount of certain cells of leukocytes.It is their increasing talk about a massive allergic reaction in the body.
may also appoint special immune panel.In it you can find the increase in the number of certain immune cells.Including described above to the skin tropic and T-lymphocytes.
Stevens-Johnson syndrome treatment
Stevens-Johnson syndrome requires immediate treatment.This is a serious medical emergency, and every minute of delay brings the patient to the possible development of serious complications.
Stevens-Johnson syndrome is not treated under normal conditions or conditions of separation of therapy: the patient is transferred to the burn unit or intensive care unit, and there perform their treatment.
In the first row of therapy Stevens-Johnson syndrome are corticosteroids.It is a substance with a very powerful influence and that this influence can help stop a massive allergic reaction in the body, which is the root cause of Stevens-Johnson syndrome.It is best to introduce injectable versions of these drugs: they will be able to provide a faster time-action.The most common syndrome is treated by representatives of the group of corticosteroids such as prednisone and dexamethasone.
addition to the immediate and speedy treatment of Stevens-Johnson syndrome corticosteroids prescribed use of electrolyte solutions.Like corticosteroids, these solutions are best given as a drip, where the drug will be administered bolus (to feed a large number of substances in 1 minute).
Since Stevens-Johnson syndrome affected certain amount of skin that may appear and bacterial complications.In order to stop their display to the main circuit appoint additional therapy and antibiotics.It is important to know that antibiotics are selected individually for each case of the disease, given the tolerability to the effects of the drug.
addition to the general treatment of Stevens-Johnson syndrome, and local treatment is performed, which consists in the right toilet and care for the skin and the right gentle removal of necrotic skin residues.This will be good assistants antiseptic solution.In most cases solutions of hydrogen peroxide and manganese (potassium permanganate).
In addition to these treatments there is another important method.This identification of the causes that triggered the development of Stevens-Johnson syndrome and removing it from the range of continuous human exposure.For example, when the drug Stevens-Johnson syndrome need to find a cure for the harmful effect and completely eliminate it from human consumption in the treatment regimen.
Patients must necessarily adhere to a strict diet aimed at reducing vysokoallergennogo status of used products.It is forbidden to consume citrus fruits, candies, sweets, chocolate and all sorts of fish.