Stevens Johnson Syndrome - Essay Example

Stevens Johnson Syndrome due: Concept map Immunocompromised Skin infection Medication (antibiotic) Allergic reaction Antigen presentation & production of tumor necrosis factor Recruitment & augmentation of T-lymphocyte proliferation Activated CD8+ Lymphocytes Induce epidermal cell apoptosis Cytotoxic CD8+ T- cells killed Cold-like symptoms develop Cytolytic protein granulysin Epidermal destruction Development of rush Sloughing and detachment of maculopapular rash Stevens Johnson Syndrome Based on this case, I diagnose a patient with Stevens Johnson Syndrome.

This skin disorder was triggered by an allergic reaction of the medication given (Bactrim DS). According to the case, the patient begun having flu-like symptoms i.e. fever, sore throat, chills, headache and malaise, and arthralgias; followed by a maculopapular rash that developed sloughing and detachment of about 10% body surface area, found on the palms, soles, and dorsum of the hands. These symptoms development points out to Stevens Johnson Syndrome; furthermore, the skin lesions resembling atypical lesions and or purpuric macules give more depth on this situation (Brashers, 2006).

  History questions or physical examination aspects that might help support the diagnosis History questions entail the medical history of the patient. This includes past allergies, past infections, allergies to which medications, full drug history, and current medication taken. In addition, family and personal history is relevant for proper diagnosis. This includes a history of dermatitis, childhood eczema, hay fever, and asthma. Enquiring more on rash development and if the disease has ever occurred is critical in determining the diagnosis.

Personal history is also relevant in supporting the diagnosis. This includes inquiring about any recent travel to specific regions that are prone to trigger this condition, patient’s occupation, and lifestyle. A comprehensive physical examination must be made with particular attention to the skin and mucous membranes. Critical areas include the nose, lips, mouth, anus, vagina (if patient is a female), and conjunctiva. This will require the patient to be naked so that some parts where the patient may not see the rash can be evaluated by a medical practitioner.

Such areas include back, soles, perineum, and buttocks. Furthermore, histopathologic tests of the skin and ocular examination have to be done. Recommendations for managing this condition Stevens Johnson Syndrome is an emergency that needs immediate hospitalization in burn or intensive care units. The initial treatment in managing this condition is based on determining the cause. In this case, the condition is triggered by medication, thus, discontinuation of the medication is recommended (Sooriakumaran et al. 2006). According to Patterson et al. (2009), early discontinuation of the causative drug has been proven to improve survival rate in affected patients (p. 234). As a precaution, all medications ought to be discontinued, to minimize complications.

Next, oral lesions are administered mouthwashes. According to McCance & Huether (2014) anesthetics are used in pain control, as the pain is intense (p. 1627). In addition, the patient must be allowed to rehydrate their bodies via intravenous fluid repletion, the ocular surface is lubricated. The patient has to be given a consult by an ophthalmologist because of the eye damage risk (Wright & Spiegel, 2006). Regions which contain shed skin ought to be covered with compresses of Burow or saline solution and tetanus shots must be administered to the patients.

Special attention is given to hemodynamic and airway stability. Nutrition also plays a vital role in managing this condition. Proper management entails supportive care to the patient as the treatment is symptomatic. A vital pointer is that the environment must be hygienic and sterile, to prevent any infection. References Brashers, V. L. (2006). Clinical applications of pathophysiology: An evidence-based approach. St. Louis (MO: Mosby/Elsevier. In McCance, K. L., & In Huether, S. E. (2014). Pathophysiology: The biologic basis for disease in adults and children.

Patterson, R., Grammer, L. C., & Greenberger, P. A. (2009). Pattersons allergic diseases. Baltimore, MD: Wolters Kluwer Health/Lippincott Williams & Wilkins. Sooriakumaran, P., Jayasena, C., & Sharman, A. (2006). 100 medical emergencies for finals. Oxford: Radcliffe Pub. Wright, K. W., & Spiegel, P. H. (2006). Handbook of pediatric eye and systemic disease. New York: Springer.