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Treatments and drugs
By Mayo Clinic staffStevens-Johnson syndrome requires hospitalization, often in an intensive care unit or burn unit.
Stopping medication causes
The first and most important step in treating Stevens-Johnson syndrome is to discontinue any medications that may be causing it. Because it's difficult to determine exactly which drug may be causing the problem, your doctor may recommend that you stop taking all nonessential medications.
Supportive care
Currently there are no standard recommendations for treating Stevens-Johnson syndrome. Supportive care you're likely to receive while hospitalized includes:
- Fluid replacement and nutrition. Because skin loss can result in significant loss of fluid from your body, replacing fluids is an important part of treatment. You may receive fluids and nutrients through a tube placed through your nose and advanced into your stomach (nasogastric tube).
- Wound care. Cool, wet compresses will help soothe blisters while they heal. Your health care team may gently remove any dead skin, and then place a dressing with a topical anesthetic over the affected areas, if needed.
- Eye care. Because of the risk of eye damage, your treatment should include consultation with an eye specialist (ophthalmologist).
Medications
Medications commonly used in the treatment of Stevens-Johnson syndrome include:
- Pain medication to reduce discomfort
- Antihistamines to relieve itching
- Antibiotics to control infection, when needed
- Topical steroids to reduce skin inflammation
In addition, you may receive one of the following types of medications that are currently being studied in the treatment of Stevens-Johnson syndrome:
- Intravenous corticosteroids. For adults, these drugs may lessen the severity of symptoms and shorten recovery time if started within a day or two of when symptoms first appear. For children, they may increase risk of complications.
- Immunoglobulin intravenous (IVIG). This medication contains antibodies that may help your immune system halt the process of Stevens-Johnson syndrome.
Skin grafting
If a large area of your body is affected, skin grafting — removing skin from one area of your body and attaching it to another or using a synthetic skin substitute — may be necessary to help you heal. This treatment is only rarely required.
If the underlying cause of Stevens-Johnson syndrome can be eliminated and the skin reaction stopped, your skin may begin to grow again within several days. In severe cases, full recovery may take several months.
- Nirken MH, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: Clinical manifestations; pathogenesis; and diagnosis. http://www.uptodate.com/home/index.html. Accessed Dec. 13, 2010.
- High WA, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: Management, prognosis, and long-term sequelae. http://www.uptodate.com/home/index.html. Accessed Dec. 13, 2010.
- Evans J. Topical treatment protocol for Stevens-Johnson syndrome and toxic epidermal necrolysis. Journal of Wound Ostomy & Continence Nursing. 2009;36:509.
- Hazin R, et al. Derm diagnoses you can't afford to miss. The Journal of Family Practice. 2009;58:298.
- Knowles S, et al. Clinical risk management of Stevens-Johnson syndrome/toxic epidermal necrolysis spectrum. Dermatologic Therapy. 2009;22:441.
- Ward KE, et al. Severe adverse skin reactions to nonsteroidal anti-inflammatory drugs: A review of the literature. American Journal of Health-System Pharmacy. 2010;67:206.
- Usatine RP, et al. Dermatologic emergencies. American Family Physician. 2010;82:773.
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