Stevens-Johnson Syndrome (SJS) is a rare yet deadly skin disease. It is often the result of an allergic reaction to certain medications. Very few people develop SJS in a given year, meaning hardly anyone understands the seriousness of it. Due to its rarity, many doctors misdiagnose this condition or miss it entirely. When that occurs, SJS can develop into something worse.

While experts once thought these two were separate diseases, they have since discovered that SJS and Toxic Epidermal Necrolysis (TEN) exist on the same disease spectrum. Often, when SJS goes unchecked, it will quickly develop into the far more deadly TEN.

As is the case with SJS, very few people are aware of TEN. Typically, only those who develop this disease and the doctors who treat them are familiar with the severity of TEN. Due to this, this skin disorder can prove exceptionally dangerous. Often, when doctors misdiagnose your condition or miss SJS or TEN altogether, you might be within your rights to file a medical malpractice lawsuit.

Wormington & Bollinger have grown quite familiar with both SJS and TEN over the years. We have helped countless clients recover compensation for the damages they suffered, whether from their allergic reaction or due to their doctor misdiagnosing them. If you or someone you love suffers from Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis, contact our medical malpractice law firm today.

SJS vs. TEN 

To fully understand Toxic Epidermal Necrolysis, you also need to understand what Stevens-Johnson Syndrome is. It is a rare skin disease, which attacks the mucous membranes of the eyes, mouth, and genitals. While rare, you should still treat this disease with the utmost seriousness. If left unchecked, it can lead to fatal results.

Whenever you first get SJS, you should seek treatment as soon as possible. If not, it will worsen, eventually developing into TEN. An identifying characteristic of TEN is that while SJS affects roughly 10% of the skin, TEN affects more than 30%. Not only that, but it is far more deadly than SJS. Additionally, the mucous membranes of the body suffer extensive damage.

It’s crucial that you recognize the symptoms of SJS to ensure that it does not develop into TEN. Some common signs and symptoms to keep an eye out for include:

• Fever
• Skin pain
• Reddish/purplish rash that spreads across the skin
• Blisters or sores on the mucous membranes
• Skin shedding
• Sore throat
• Fatigue
• Cough
• Burning sensation
• Burning eyes
• Swelling eyes

SJS can quickly develop into TEN, so you must act fast. TEN is a life-threatening emergency that requires immediate medical attention. While SJS only kills about 10% of those who develop this disease, TEN claims the lives of nearly 50% of patients with this condition.

The process of TEN is relatively quick. Within a few days of the onset of your symptoms, your skin begins to peel with or without blistering. These symptoms can last for several days. Recovery can take anywhere from 3-6 weeks. However, in severe cases, it can take months.

Causes

Just as SJS develops, the cause of Toxic Epidermal Necrolysis is an adverse reaction to certain medications. These reactions account for up to 95% of all TEN cases. Typically, you will experience these reactions within the first eight weeks of taking a drug. Then the condition quickly progresses.

Some common medications that can lead to allergic reactions that cause TEN includes:

• Anticonvulsants
• Anti-gout medications
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Sulfonamide antibiotics
• Antiepileptic medications
• Antiretroviral medications

These are just a handful of medications that can cause this skin disease. However, drugs are not the only cause of this skin disease. In some cases, infections can also lead to TEN. Bacteria known as Mycoplasma pneumonia, which leads to a contagious respiratory infection (also referred to as walking pneumonia), can cause a reaction that leads to TEN.

Risk Factors of TEN

This skin disease is serious and can be life-threatening. Unfortunately, there are a host of factors that can drastically increase your risk of developing TEN. While medications are often the most common cause of this disease, these other factors increase your risk:

• Age: While anyone can develop SJS or TEN, it mainly affects older adults.
• Weakened Immune Systems: Individuals with weakened immune systems are more likely to develop TEN since their bodies can’t fight it off. Conditions such as cancer or HIV increase your risk.
• AIDS: To expand on the above, those living with AIDS are up to 1,000 times more likely to develop TEN.
• Genetics: The presence of the gene HLA-B*1502 increases your risk of developing TEN when taking particular drugs.
• Medical History: If you have had SJS or TEN in the past or have an immediate family member who also had this disease, you are more likely to develop it.

Treatment

To diagnose TEN, your doctor will perform a physical exam, inspecting your skin for rashes, blisters, peeling, infection, mucosal involvement, and more. They will also perform a skin biopsy (testing a sample of infected skin) and a blood test to identify any infection. They might also recommend a blood or skin culture. Typically, a physical exam is enough to diagnose TEN.

While your treatment will vary based on your age, medical history, the disease’s progression, and the parts of your body most affected, all TEN patients must be cared for in a burn unit. The skin damage of TEN is similar to that of burn victims. Patients experience blisters and skin peeling. The process is quick but leaves large raw areas that may ooze. This process is also painful.

Doctors will use ointments and bandages to prevent further skin damage and protect your raw skin from losing fluids and infection. Naturally, as you lose skin, you lose fluids and electrolytes. You will receive an IV fluid to keep you hydrated and maintain electrolyte balance. You may also receive antibiotics to fight off infections.

Long-Term Complications

Because TEN causes more damage than SJS, the long-term complications are also more extensive. You might experience permanent skin damage and scarring. Bumps, scars, and discoloration might also appear on healed skin. These issues can cause hair loss, as well as affecting how your fingernails and toenails grow.

TEN can also lead to eye problems. Due to the nature of the disease, it can cause corneal scarring, dry eye, ingrown eyelashes, and, in rare cases, blindness. Additionally, you might also experience difficulty breathing and coughing. In some instances, TEN leads to respiratory failure. Sepsis (a blood infection) can also occur in TEN patients. Since the infection enters your bloodstream, it spreads quickly and is life-threatening.

Contact Wormington & Bollinger 

Toxic Epidermal Necrolysis is a rare yet life-threatening skin disease. It is a much more advanced form of Stevens-Johnson Syndrome, affecting more skin on the body. TEN typically develops when SJS goes untreated. Often, this is the result of a doctor misdiagnosing your condition or missing the disease altogether.

If you suffer from SJS/TEN because of a doctor’s misdiagnosis, contact Wormington & Bollinger to learn what your options are.