Stevens-Johnson syndrome
Causes of Stevens-Johnson syndrome
In children, Stevens-Johnson syndrome is usually triggered by a viral infection, such as
- mumps
- flu
- herpes-simplex virus, which causes cold sores
- Coxsackie virus, which causes Bornholm disease
- Epstein-Barr virus, which causes glandular fever
Less commonly, bacterial infections can also trigger the syndrome.
In adults, Stevens-Johnson syndrome is often caused by an adverse reaction to medication. The medications associated with a high risk of Stevens-Johnson syndrome are:
- allopurinol
- carbamazepine
- cotrimoxazole and other anti-infective sulfonamides including sulfasalazine, sulfadiazine, sulfadoxine and sulfafurazole
- lamotrigine
- nevirapine
- certain types of non-steroidal anti-inflammatory drugs (NSAIDs) including meloxicam, piroxicam and tenoxicam
- phenobarbital
- phenytoin
- sertraline
As a result of the associated risk, a thorough evaluation of the expected benefits of treatment is required when prescribing the above medications. Doctors are advised to carefully consider using these medications as first-line treatments, particularly if there are safer alternatives.
Medications that are classed as having a significant but lower risk of causing Stevens-Johnson syndrome include:
- other types of NSAIDs including diclofenac, indomethacin, lonazolac, etodolac, aceclofenac, sulindac and ketorolac
- aminopenicillins including amoxicillin and bacampicillin
- cephalosporins including cefaclor, cefalexin, cefapirin, cefatrizine, cefixime, cefonicide, cefotiam, cefpodoxime, ceftibutem, ceftriaxone and cefuroxime
- macrolides including azithromycin, clarithromycin, erythromycin, midecamycin, pristinamycin, roxithromycin and spiramycin
- quinolones including ciprofloxacin, grepafloxacin, levofloxacin, norfloxacin and ofloxacin
- tetracyclines including doxycycline, metacycline and minocycline
Its important to emphasise that Stevens-Johnson syndrome is rare, and the overall risk of getting the syndrome is low, even for people using "high risk" medications (one in 1,000 to one in 100,000).
Medically Reviewed by a doctor on 21 Dec 2018
Introduction
Read about Stevens-Johnson syndrome, which is a rare but serious disorder that affects the skin and mucous membranes.
Symptoms of Stevens-Johnson syndrome
Skin pain is the most common symptom of Stevens-Johnson syndrome. Flu-like symptoms are also usually present during the initial stages, and may include: feeling generally unwell a high temperatur
Causes of Stevens-Johnson syndrome
In children, Stevens-Johnson syndrome is usually triggered by a viral infection, such as mumps flu herpes-simplex virus, which causes cold sores Coxsackie virus, which causes Bornholm diseas
Risk factors
Risk factors for Stevens-Johnson syndrome may include: viral infections such as herpes, hepatitis, viral pneumonia or HIV a weakened immune system as a result of HIV or AIDS , autoimmune condi
Diagnosing Stevens-Johnson syndrome
Stevens-Johnson syndrome should be diagnosed by a dermatologist (skin specialist). A diagnosis is often based on a combination of your: symptoms physical examination medical history (including any
Treating Stevens-Johnson syndrome
If Stevens-Johnson syndrome is suspected, you or your child will be immediately referred to hospital for treatment. Without treatment, the symptoms can become very severe and be life-threatening. Sev
Complicationsof Stevens-Johnson syndrome
As Stevens-Johnson syndrome severely affects the skin and mucous membranes, it can cause a number of complications. These include: skin changes when your skin grows back it may be uneven in colour
Preventing Stevens-Johnson syndrome
If Stevens-Johnson syndrome has been caused by an adverse reaction to a medication, you'll need to avoid taking this medication and other similar medications. Other family members may also want to avo
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