Fixed Drug Eruptions and Stevens-Johnson Syndrome

Overview

Fixed drug eruptions (FDEs) and Stevens-Johnson Syndrome (SJS) are severe cutaneous adverse reactions to medications. These conditions require prompt diagnosis and management.

Clinical Presentation and Diagnosis of Stevens-Johnson Syndrome

Signs and Symptoms

• Prodromal flu-like symptoms (fever, malaise, sore throat)
• Painful erythematous or purpuric macules
• Blistering leading to epidermal detachment
• Mucosal involvement (oral, ocular, genital)

Causes and Risk Factors

SJS is commonly triggered by medications such as sulfonamides, anticonvulsants, and NSAIDs. Genetic predisposition, infections, and immune-mediated responses play a role.

Diagnosis

Diagnosis is clinical, supported by histopathological findings (necrotic keratinocytes, lymphocytic infiltration) and laboratory tests.

Treatment and Management

Management includes immediate discontinuation of the causative drug, supportive care, wound management, and immunomodulatory therapy.