The Ocular Surface Research & Education Foundation Presents:
Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis
By Hosam Sheha, M.D., Ph.D. and Scheffer C. G. Tseng M.D., Ph.D. Stevens-Johnson Syndrome (SJS) is an immune-complex–mediated hypersensitivity disorder
which typically involves the skin and the mucous membranes.
SJS is a serious systemic
disorder with the potential for severe morbidity and even death. Significant involvement of
oral, nasal, eye, vaginal, urethral, GI, and lower respiratory tract mucous membranes may
develop in the course of the illness.
The severe variant of SJS showed extensive skin
involvement resulting in toxic epidermal necrolysis (TEN). Although SJS/TEN is
considered one of the most devastating ocular surface diseases which causes corneal damage
and threatens vision, management of ocular involvement may be compromised because
more attention is directed to maintaining the vital functions during the acute stage.
Furthermore, upon eye examination of patients suffering SJS/TEN at the acute stage it is
difficult to recognize hidden conjunctival inflammation and ulceration deep in the fornix
and tarsus. Inadequate control of ocular surface inflammation and ulceration at the acute
stage will set in a vicious cycle, leading to the chronic stage of scarring (cicatrix), which then
contributes greatly to subsequent corneal complications.
  
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