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Erythema Multiforme MajorAka: Stevens-Johnson Syndrome, Stevens Johnson

Pathophysiology
1. Severe clinical variant of Erythema Multiforme
2. Previously thought to be part of same spectrum as minor
  1. Now thought to be clinically distinct
Symptoms
1. Prodrome
  1. Fever
  2. Malaise
  3. Prostration
2. Sudden widespread skin eruption
Signs
1. Target lesions (See Erythema Multiforme)
  1. Widespread skin involvement
2. Mucosal bullae (severe in 20% of cases)
  1. Oral Mucosa may lead to inadequate oral intake
  2. Respiratory may lead to respiratory distress
  3. Conjunctiva may lead to ocular complications
Associated Conditions
1. Toxic epidermal necrolysis
Complications
1. Secondary infection
Prognosis
1. Severe complications: 3-15%
  1. Mortality
  2. Respiratory failure

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This page was written by Scott Moses, MD, and was last revised 1/26/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.