Stevens-Johnson Syndrome (SJS)

Stevens-Johnson syndrome (SJS) is a rare but serious disorder of the skin and mucous membranes, usually triggered by medications. It is a medical emergency requiring hospitalization.

Quick Facts

  • ICD-10: L51.1
  • Triggers: Medications, infections
  • Emergency: Yes — requires hospital care

Emergency Warning

Seek immediate emergency care for:
  • Painful rash spreading on the skin
  • Blisters on skin, lips, eyes, mouth, or genitals
  • Sloughing of the skin
  • Fever with rash
  • Recent new medication followed by rash

Symptoms

  • Flu-like symptoms a few days before the rash (fever, sore throat, cough)
  • Painful red or purplish rash that spreads
  • Blisters on skin and mucous membranes (mouth, eyes, genitals)
  • Sloughing of the top layer of skin
  • Painful eyes, redness, discharge

When skin involvement exceeds 30% of body surface, it is called toxic epidermal necrolysis (TEN), a more severe form on the same spectrum.

Common Triggers

  • Medications (most common): allopurinol, anticonvulsants (carbamazepine, lamotrigine, phenytoin), sulfa antibiotics, NSAIDs, nevirapine
  • Infections: Mycoplasma pneumoniae, herpes simplex, HIV
  • Some cases have no identified trigger

Treatment

  • Immediate hospitalization, often in a burn unit
  • Stop the suspected medication immediately
  • Fluid replacement and nutrition support
  • Wound care
  • Eye care to prevent long-term damage
  • Pain control
  • Cyclosporine, IVIG, or other therapies in selected cases

When to See a Doctor

Any painful rash that develops in someone recently started on a new medication is a medical emergency. Do not wait.

Frequently Asked Questions

Can SJS happen again?

Yes — anyone who has had SJS must permanently avoid the triggering medication and chemically related drugs. Wear medical-alert identification.

Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • American Academy of Dermatology. Stevens-Johnson Syndrome.