Abstract

A REVIEW ON STEVEN JOHNSON SYNDROME WITH ITS PHARMACOLOGICAL AND NON-PHARMACOLOGICAL THERAPY

Yamini Krishna K.*, Sai Lakshmi Lahari N., Harshitha B., Nithish V., Thirumala Naik Dr. K.

ABSTRACT

Steven Johnson Syndrome is a rare disease characterized by extensive epidermal necrosis which leads to shedding of skin. SJS is a critical life threatening mucocutaneous adverse reaction caused by drugs followed by infections, which is usually A type Ⅳ hypersensitivity reaction recognized as dysregulation of cellular immunity. Identifying the causative drug may often be complicated due to polypharmacy and self-medication. Evidence suggests that 85% cases of SJS are caused by medicine that has been initiated prior eight weeks of presenting disease. Class of Medications that cause SJS are antimicrobials, anticonvulsants, analgesics, antidepressants and others like allopurinol, sulfasalazine and diltiazem. Also, Genetic factors like human leukocyte antigen (HLA) allotypes and family history of SJS are risk factors for developing SJS. It involves both immunological and non-immunological mechanisms but immunological response particularly mediated by memory cytotoxic T cells is its primary involvement. The severity of steven johnson syndrome is assessed using SCORTEN. SJS is treated with corticosteroids, intravenous immunoglobulins, by plasmapheresis and by cyclosporine. Also, supportive therapy and nutritional support is advised in treating SJS. Conclusion: This study helps in reviewing the overall causes, symptoms, mechanism of immunological responses, evaluation and treatment of SJS along with nonpharmacological therapy which provides a detailed information regarding SJS.

Keywords: Steven Johnson Syndrome [SJS], human leukocyte antigen (HLA), hypersensitivity, SCORTEN, polypharmacy.