Pathogenic process is allergicorigin - acute bullous reaction spreads in the mouth, on mucous eyes and urinary organs. This pathology is characterized by an extremely severe form of development and course.
For information about the illness released in 1922. After some time, the disease was given the names of the scientists who first identified it. Even Stevens-Johnson syndrome known as malignant exudative erythema. The main clinical feature of this skin disease is considered the formation of well-defined water blisters on the skin and mucous membranes of the patient.
If we talk about age limits, the syndromeStevens-Johnson is not selective in this regard: the illness tends to hit a person of any age. The peak incidence observed among the working-age population from 20 to 40 years, but the children in the first 3 years, only a few cases have been registered. falls 2-6 cases per year in an average of 1 million. man. As practice shows, Stevens-Johnson syndrome are more prone to man.
Causes of disease
At the core of the syndrome is an allergic reaction of immediate type. Among the factors that may be a precursor of the disease, identify the following:
- agents of infectious origin;
- malignant disease;
- unknown causes.
In children, Stevens-Johnson syndrome is a consequence of viral infections such as simple herpes. measles. piggy, Chicken pox, adenovirus infection. Among the bacterial point of provoking factors tuberculosis, Salmonellosis, tularemia and gonorrheaAmong fungal - trichophytosis, histoplasmosis and deep mycosis.
The most common cause of rapidsyndrome of adult patients is the administration of drugs or the development of cancer. Among the medications particular danger in terms of the emergence of severe allergies are antibacterial drugs, NSAIDs, sulfonamides and the central nervous system regulators. The probability of developing Stevens-Johnson syndrome is increased if the patient has been diagnosed with lymphoma or carcinoma.
If you get to the source of the disease failed and caused the abnormal factor has not been determined, the disease is called idiopathic (having unknown causes).
The clinical picture of the disease
To confirm or refute the diagnosistreated by a dermatologist. First of all, the expert will assess the existing patient's characteristic symptoms of this syndrome, then will ask the patient in detail, to set the factor that caused the development of pathology.
In order to confirm the diagnosis 'Stevens-Johnson syndrome', use special diagnostic methods:
- A skin biopsy. As a result of the histological analysis of the patient detect dying cells of the epidermis, subepidermal blisters and set lymphocytic infiltration.
- Clinical blood test. These data establish the existence of signs of inflammatory response, coagulation procedure confirms the disorder of blood clotting, and as a result Biochemical analysis of blood a low protein concentration becomes apparent. Specialist will pay special attention to the data of immunological blood tests, which in the presence of Stevens-Johnson syndrome will certainly show a sharp jump up in the number of T cells and specific antigens.
If the doctor studies stillwill have doubts about the validity of the diagnosis, the patient will be exposed to additional analysis, among which are the coprogram, biochemical urine test, ultrasound of the kidneys and bladder, Zimnitsky sample, X-ray examination of the lungs. Sometimes a diagnostic study involved other doctors of narrow specialization - urologist, nephrologist, ophthalmologist, otolaryngologist and pulmonologist.
Treatment of the disease
our website notes that the forecast syndrome treatmentStevens-Johnson generally positive. Under the influence of the intensity of the appropriate combination therapy severe symptoms usually goes into decline after 8-10 days after starting treatment. After a while and returns to normal body temperature, and skin and mucosal inflammation out.
Generally, significant improvementthe patient or his full recovery occurs after about 1 month. Despite the severity of the disease, the manifestations of the syndrome on the skin appear in alternating seizures: they decrease, then become inflamed again. This happens within 2-3 weeks of responsible treatment. After the final recovery, Stevens-Johnson Syndrome will be reminded for a long time by the spots of alopecia (places devoid of hairs) on the eyebrows and eyelashes. As already noted, the prognosis cannot be called favorable if the course of the underlying disease in the patient is complicated by corneal leukemia, blindness, or the appearance of synechia.
The basis of the treatment of Stevens-Johnson syndromemake high doses of glucocorticoid hormones. Since the oral cavity of the patient is often severely impaired blisters, administration of drugs by injection do. Gradually reduce the dose of drugs, there is a visible improvement immediately after the victim's state of health.
To cleanse the blood of toxic immunecomplexes, which appear with the development of the syndrome, the patient is subjected to a cascade plasma filtration hemosorption, immunoadsorption and plasmapheresis membrane.
Equally important for human recoveryIt has abundant drinking regime and normalization of daily diuresis. For the general strengthening of the body the patient appoint multivitamin preparations with the obligatory presence of high doses of calcium and potassium. Prevention of secondary infection is performed by applying local and systemic antibiotics.