Health Watch: A Build Up of Some Medications Can Cause Fatal Skin Reactions Including Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis by Texas Stevens-Johnson Syndrome Lawyer and Fatal Skin Drug Reaction Lawyer Jason S. Coomer
Stevens–Johnson Syndrome (SJS) and Toxic
Epidermal Necrolysis (TEN) are two forms of a
life-threatening condition affecting the skin in which cell
death causes the epidermis to separate from the dermis.
With this condition a person's skin and mucous membranes
react severely to a medication or infection. Often,
Stevens-Johnson syndrome begins with flu-like symptoms,
followed by a painful red or purplish rash that spreads and
blisters, eventually causes the top layer of a person's skin
to die and shed. The syndrome is thought to be a
hypersensitivity complex affecting the skin and the mucous
membranes. Persons with Stevens-Johnson syndrome (SJS)
should seek immediate medical treatment.
Medications are thought to be the most
common cause of Stevens-Johnson Syndrome and Toxic Epidermal
Necrolysis. More than 200 medications have been reported in
association with SJS/TEN. It is more often seen with drugs
with long half-lives compared to even a chemically similar
related drug with a short half-life. A half-life of a
medication is the time that half of the delivered dose
remains circulating in the body. The most commonly
implicated medications are antibacterial sulfonamides. Other
drugs that have been associated with Stevens-Johnson
Syndrome include: Anti-gout Medications; Non Sterodal
Anti-Inflammatory Drugs (NSAIDs); Sulfonamides; Penicillins;
Ibuprofen (Advil, Children's Advil, Motrin, Children's
Motrin, Advil Allergy Sinus Tablets; Advil Cold & Sinus
Tablets; Advil Liqui-Gels; Advil Migraine Capsules;
Children's Motrin Chewable Tablets; Motrin Junior Strength
Chewable Tablets; Motrin Cold & Sinus Tablets; Motrin IB
Tablets; Motrin Infants' Drops, and Nuprin); Ketek;
Antibiotic; COX-2 inhibitors Bextra (Valdecoxib); Vioxx
(Rofecoxib); Celebrex (Celecoxib); Barbiturates; Sedatives;
Feldene (Piroxicam); Naproxen (Aleve); Antibiotic
Medications; Zithromax (also known as a z-pack); Keflex
(cephalexin); Coreg (carvedilol) (a popular beta blocker);
Tolectin; Antifungals; Antivirals; and Anticonvulsants.
Medical Malpractice Lawsuits Can Arise When A Doctor Misdiagnoses Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis and Prescribes Additional Medications to the Patient
When diagnosing and treating a person
with Stevens–Johnson Syndrome (SJS) and Toxic Epidermal
Necrolysis (TEN), it is important to identify the condition
early and discontinue the medications that may be causing
the skin reaction. In identifying and diagnosing
Stevens–Johnson Syndrome (SJS) and Toxic Epidermal
Necrolysis (TEN), it is also important to determine what
medications the patient has been taking and if prior to the
rash appearing, the patient suffered from a flu-like illness
resembling an upper respiratory tract infection with fever,
cough, sore throat, difficulty swallowing, runny nose, sore
red eyes, conjunctivitis, as well as general aches and
pains.
After the flu-like symptoms, there is
typically an abrupt onset of a tender/painful red skin rash
starting on the trunk and extending rapidly over hours to
days onto the face and limbs. These skin lesions typically
include changes in surface color, target lesions, and
blisters. The changes in surface color are typically
flat, red and diffuse (measles-like) or purple (purpuric)
spots. The target lesions or erythema multiforme
consists of a polymorphous eruption of macules, papules, and
characteristic “target” lesions that are symmetrically
distributed with a propensity for the distal extremities.
The blisters are typically flaccid, that begin to merge to
form sheets of skin detachment, exposing red, oozing dermis.
These blisters are positive for the Nikolsky sign which
means if the blisters are rubbed gently skin will
exfoliation the outermost layer. Nikolsky's sign is almost
always present in TEN.
Developing Stevens–Johnson Syndrome (SJS)
or Toxic Epidermal Necrolysis (TEN) constitutes a
dermatological emergency and failure to timely act can
result in a more severe reaction or even death. When a
person has Stevens–Johnson Syndrome (SJS) or Toxic Epidermal
Necrolysis (TEN), immediate treatment should be sought and
all medications should be discontinued, particularly those
known to cause SJS-TEN reactions.
A skin biopsy or autopsy is usually
required to confirm the clinical diagnosis and to exclude
Staphylococcal Scalded Skin Syndrome (SSSS) and other
generalised rashes with blisters.
Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Are Variants of the Same Skin Condition and Can Be The Basis Of A Stevens-Johnson Syndrome Lawsuit or a Toxic Epidermal Necrolysis Lawsuit
Stevens–Johnson Syndrome (SJS) and Toxic
Epidermal Necrolysis (TEN) are variants of the same skin
condition. The condition presents as severe mucosal
erosions with widespread skin lesions. In Stevens–Johnson
Syndrome (SJS), epidermal detachment involves less than 10
percent of the total body skin area; transitional
Stevens–Johnson Syndrome (SJS)-Toxic Epidermal Necrolysis
(TEN) is defined by an epidermal detachment between 10
percent and 30 percent; Toxic Epidermal Necrolysis (TEN) is
defined by a detachment greater than 30 percent.
Skin reactions during SJS-TEN can be
horrific and death from or suffering from the condition
either Stevens–Johnson Syndrome or Toxic Epidermal
Necrolysis can be a horrific experience for everyone
involved. To help the patient recover it is essential
Even worse
Severe skin adverse drug reactions can
result in death. Toxic epidermal necrolysis (TEN) has the
highest mortality (30-35%); Stevens-Johnson syndrome and
transitional forms correspond to the same syndrome, but with
less extensive skin detachment and a lower mortality
(5-15%). Hypersensitivity syndrome, sometimes called Drug
Reaction with Eosinophilia and Systemic Symptoms (DRESS),
has a mortality rate evaluated at about 10%.
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