Stevens-Johnson syndrome (SJS)
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are degenerative skin disorders differentiated by percentage of involved body surface area.
PRESENTATION
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are degenerative skin disorders characterized by severe inflammation, redness, and skin shedding or sloughing. These disease processes are similar. Moreover, only differentiating in the percentage of the total body surface area (TBSA) affected with SJS involving less than 10% and TEN more than 30%. However, there is some cross-over between 10-30% diagnosed as either SJS or TEN. Both usually occur as a reaction to a "trigger," the most common triggers being certain medications, such as sulfa drugs or seizure medications. Every patient is different, and all experiences with Stevens-Johnson syndrome and toxic epidermal necrolysis are unique with variations in severity, complexity, and recovery.
TREATMENT
These skin disorders not only ravage the epithelial tissues of the body but leave the patient susceptible to infection, multi-organ system failure, and other severe complications. For this reason, individuals affected by SJS or TEN must receive treatment at a multi-disciplinary burn center that has experience in healing these disorders. Stevens-Johnson syndrome and Toxic epidermal necrolysis cause the body to go through a complete regeneration. Additionally, this can result in requiring skin graft surgeries. Patients may even require intubation on a ventilator to protect the airway.
PATIENT STORY
"Before developing SJS/TEN, I had never been admitted in the hospital, never really been sick, had any diagnosis of diabetes or hypertension, or any other comorbidities. I ran two miles every day. I did not have any health issues. However, to this day, my providers still do not know what caused my condition."
Given her health and the life she led, Dr. Worthy often heard people say, "'Well, you must have asked God a million times why you?' Never," she said. "Not once did I ever ask God why me. Instead, I asked Him, 'Why not me?'
Last year seems like ages ago now that Dr. Worthy has resumed her role as the Assistant Dean of Undergraduate Studies in the College of Nursing at the University of South Carolina. As a nurse and a professor educating future nurses, she is in the right place and profession. She is so proud and thankful for all the nurses who were and still are a part of her SJS/TEN journey.