Stevens-Johnson syndrome physical examination: Difference between revisions
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===Vital Signs=== | ===Vital Signs=== | ||
*Fever is frequently seen in patients of SJS | *[[Fever]] is frequently seen in patients of SJS | ||
*Hypotension may be seen | *[[Hypotension]] may be seen | ||
*Tachycardia may be seen | *[[Tachycardia]] may be seen | ||
===Skin=== | ===Skin=== | ||
* Skin examination of patients with SJS shows confluent redness that is seen as red or reddish purple macules that enlarge to form bullae, vesicles and may rupture later to leave denuded skin underneath. | * Skin examination of patients with SJS shows confluent redness that is seen as red or reddish purple [[macules]] that enlarge to form bullae, vesicles and may rupture later to leave denuded skin underneath. | ||
* Can occur anywhere on the body but more common on trunk and extremities and may involve palms and soles | * Can occur anywhere on the body but more common on trunk and extremities and may involve palms and soles | ||
* Nikolsky sign may be positive- Sloughing of the skin by gentle lateral pressure on the erythematous skin | * Nikolsky sign may be positive- Sloughing of the skin by gentle lateral pressure on the erythematous skin | ||
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* Back examination of patients with SJS is usually normal. | * Back examination of patients with SJS is usually normal. | ||
===Genitourinary=== | ===Genitourinary=== | ||
* Genitourinary examination of patients with SJS can show erythema, edema, ulcerations leading to urethritis, urinary retention, vulvovaginitis as a result of mucosal involvement | * Genitourinary examination of patients with SJS can show erythema, edema, ulcerations leading to [[urethritis]], [[urinary retention]], [[vulvovaginitis]] as a result of mucosal involvement | ||
===Neuromuscular=== | ===Neuromuscular=== | ||
* Neuromuscular exam of Patients with SJS is usually normal | * Neuromuscular exam of Patients with SJS is usually normal | ||
Revision as of 19:41, 12 September 2018
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Differentiating Stevens-Johnson Syndrome from other Diseases |
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Risk calculators and risk factors for Stevens-Johnson syndrome physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anila Hussain, MD [2]
Overview
Common physical examination findings of SJS include rash or redness that is seen as red or reddish purple macules that enlarge to form bullae, vesicles and may rupture later to leave denuded skin underneath. Nikolsky sign may be positive which shows Sloughing of the skin by gentle lateral pressure on the erythematous skin. In addition to skin, Mucosal involvement is found mostly in oral mucosa in addition to the nasopharynx and ocular involvement-can be seen as edema, erythema, blistering, sloughing, necrosis and ulceration. In addition to these changes: fever, hypotension, and tachycardia can be seen in patients with SJS
Physical Examination
Appearance of the Patient
- Patients with SJS usually appear sick.
Vital Signs
- Fever is frequently seen in patients of SJS
- Hypotension may be seen
- Tachycardia may be seen
Skin
- Skin examination of patients with SJS shows confluent redness that is seen as red or reddish purple macules that enlarge to form bullae, vesicles and may rupture later to leave denuded skin underneath.
- Can occur anywhere on the body but more common on trunk and extremities and may involve palms and soles
- Nikolsky sign may be positive- Sloughing of the skin by gentle lateral pressure on the erythematous skin
HEENT
- Mucosal involvement is found mostly in oral mucosa in addition to the nasopharynx and ocular involvement-can be seen as edema, erythema, blistering, sloughing, necrosis and ulceration
- Slit lamp Eye exam may be abnormal with findings of Conjunctival papillae, follicles, keratinization as well as corneal keratinization, ulceration and perforation among other ocular complications[1]
- Conjunctival or eyelid Erythema
- Discharge (mucous/membranous)
Neck
- Neck examination of patients with SJS is usually normal.
Lungs
- Pulmonary examination of patients with SJS is usually normal.
Heart
- Cardiovascular examination of patients with SJS is usually normal.
Abdomen
- Abdominal examination of patients with SJS is usually normal.
Back
- Back examination of patients with SJS is usually normal.
Genitourinary
- Genitourinary examination of patients with SJS can show erythema, edema, ulcerations leading to urethritis, urinary retention, vulvovaginitis as a result of mucosal involvement
Neuromuscular
- Neuromuscular exam of Patients with SJS is usually normal
Extremities
- May show sloughing of skin with vesicles and bullae along with desquamation of skin at palms, soles or dorsum of hands
References
- ↑ Yip LW, Thong BY, Lim J, Tan AW, Wong HB, Handa S; et al. (2007). "Ocular manifestations and complications of Stevens-Johnson syndrome and toxic epidermal necrolysis: an Asian series". Allergy. 62 (5): 527–31. doi:10.1111/j.1398-9995.2006.01295.x. PMID 17313402.