What are the symptoms of Stevens-Johnson syndrome (SJS) and how are cutaneous lesions characterized?

Updated: Jan 17, 2019
  • Author: C Stephen Foster, MD, FACS, FACR, FAAO, FARVO; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Patients may complain of a burning rash that begins symmetrically on the face and the upper part of the torso. The cutaneous lesions are characterized as follows:

  • The rash can begin as macules that develop into papules, vesicles, bullae, urticarial plaques, or confluent erythema

  • The typical lesion has the appearance of a target; this is considered pathognomonic

  • In contrast to the typical lesions of erythema multiforme, these lesions have only 2 zones of color

  • The lesion’s core may be vesicular, purpuric, or necrotic; that zone is surrounded by macular erythema

  • Lesions may become bullous and later rupture, leaving denuded skin; the skin becomes susceptible to secondary infection

  • Urticarial lesions typically are not pruritic

  • Infection may be responsible for the scarring associated with morbidity

  • Although lesions may occur anywhere, the palms, soles, dorsum of the hands, and extensor surfaces are most commonly affected

  • The rash may be confined to any one area of the body, most often the trunk


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