stressed woman looking at rash on arm

Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis are both conditions that affect the skin. Both conditions are characterized by peeling skin, a rash that is red and flat to the skin, sores on mucus membranes, body aches, and a fever. The conditions are both considered to be medical emergencies and can be fatal.

SJS and TEN are rare conditions. The National Organization for Rare Diseases reports that approximately 75 percent of cases of SJS are caused by adverse reactions to medications, but they can also be the result of infections.

Researchers estimate that between five and 20 percent of SJS cases are idiopathic, meaning their causes cannot be identified.

What is the Difference Between Stevens Johnson Syndrome and Toxic Epidermal Necrolysis?

The two conditions are two stages of effectively the same condition. The symptoms described above are characterized as Stevens-Johnson Syndrome when they are less severe. When the patient’s symptoms worsen to a certain degree, the condition can be considered to have progressed to Toxic Epidermal Necrolysis.

In both conditions, blistering of the mucous membranes as well as the skin can occur — this can occur in the eyes, mouth, and genitals.

Skin Rash Statistics

Merck Manual’s Consumer Version explains the progression and difference between SJS and TEN. Stevens-Johnson Syndrome causes small areas of peeling skin, and usually covers less than ten percent of the body. When a person has peeling skin that covers between 15 and 30 percent of the body, their condition is characterized as an overlap between Stevens-Johnson Syndrome and toxic epidermal necrolysis. A patient’s condition is considered to have advanced fully to Toxic Epidermal Necrolysis when a patient has large areas of peeling skin covering over 30 percent of their body.

Unfortunately, the complications of Stevens Johnson syndrome and toxic epidermal necrolysis are severe and can be fatal. TEN is more life-threatening than SJS, particularly for older adults. Reportedly, as many as 25 percent of adults with the condition die from complications of their disease.

In contrast, the average death rate for patients of all ages is around five percent. Children can also develop the condition, but are more likely to survive — the death rate for children with TEN have an average death rate of around five percent.

Are SJS & TEN Common Skin Rashes For Adults?

Happily, Stevens Johnson Syndrome/Toxic Epidermal Necrolysis are not common skin rashes for adults. They are very rare diseases. The National Organization for Rare Diseases reports that the condition appears in around one to two people per million people in the general population. 

Though the conditions can affect people of any age, elderly patients are much more likely to develop the conditions than young people. Additionally, women are slightly more likely to develop these conditions than men.

Happily, SJS and TEN do not usually recur. In some cases, the condition might recur if a drug, like Lamictal, that promoted an adverse reaction is used again, but according to the National Organization for Rare Diseases, the disease might not recur even if the offending drug is taken again. 

Some patients may be at higher risk of developing the conditions. Reportedly, some people may be predisposed to develop them, and if this predisposition combines with an adverse reaction to a medication, they may end up with the condition. Those people whose bodies have difficulty processing medications properly may also be more at risk for SJS and TEN than others.

What Are The Potential Complications?

person in ICU bed with SJS

The complications of the two conditions are extensive. Because the mucus membranes can become damaged, eating and urinating can become very difficult. Vision can also be affected, because a patient’s eyes may swell or become crusted shut. Additionally, the conditions can cause a person’s corneas to become scarred.

Mucous membranes of the digestive tract or respiratory tract can also become impacted. This can cause a person to have diarrhea, digestive distress, a cough, difficulty breathing, or pneumonia.

Merck Manuals explains that the dangers associated with the damage to the skin can be likened to the damage from a burn. As a burn can be life-threatening, so can SJS and TEN. Reportedly, patients may develop large, raw areas of skin. These areas can become infected, which is the most common cause of death in patients with both conditions. 

Patients may also lose salts and fluids from these open wounds, and they may be susceptible to organ failure. Some patients may go into shock, or develop sepsis, which can be fatal.

Unfortunately, if a patient does fully recover from SJS or TEN, some of the complications that develop may be permanent, explains Mayo Clinic. Skin damage and scarring may be permanent, as can injury done to the eyes.

How Can Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Be Treated?

Unfortunately, there are no medications that have been proven to slow or stop a reaction causing Stevens Johnson syndrome/toxic epidermal necrolysis. Additionally, there is no treatment known to make healing faster. Healing can take years for some patients. Steroids may be used to promote healing. Some medications including intravenous immunoglobulin may also be administered to try to help healing.

Because both conditions are often associated with an adverse reaction to a medication, a patient’s care provider will often discontinue the patient’s use of the drug that may be linked to their condition. 

Patients with severe Stevens-Johnson syndrome and patients with toxic epidermal necrolysis require hospitalization, often in an intensive care unit or burn center. These facilities often have knowledge of how to prevent infection and treat the kind of damage to the skin that SJS and TEN patients develop.

Specialized dermatologists may also be helpful resources, as are ophthalmologists, if eyes are affected. 

If a patient has lost electrolytes or fluids from their wounds, they may be given fluids intravenously. Antibiotics may be used if a patient has contracted an infection, and wounds are often dressed to protect further infection. Amniotic membrane grafts may be used for damage to eyes. 

However, though the damage to skin caused by SJS and TEN may be just as damaging as that caused by burns, skin grafts do not need to be used for SJS and TEN patients, as they are for burn patients. If a person survives the disease and they recover from the condition, their skin can grow back on its own. 

Join a Free Stevens Johnson Syndrome Symptoms & Toxic Epidermal Necrolysis Lawsuit Investigation

You may qualify for this investigation under the following circumstances:

  • You or loved one took an over-the-counter or prescription drug that caused you to develop SJS or TEN;
  • You or your loved one was diagnosed with SJS or TEN; and
  • You or your loved one was hospitalized because of SJS or TEN.

You may be able to hold the drug company accountable by joining this Stevens Johnson Syndrome lawsuit investigation. 

See if you qualify by filling out the form on this page. 

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