Teaching bangsal I

Stevens-Johnson
Syndrome

Nama Anggota Kelompok

Rachmat Nugraha P
Suryani Sudirman
Ita Juniarti D
Subhiayawati B
Dewi Damayanti
Andi Rahmayanti
A. Trie Utami Rasyid

Sekar Dwi Asti Adjo

Chindy Permatasari
Ramna Minggus
Nurul Hidayah
Raehana
Nurhidayah
Hestina Lambona
Muh. Wirawan
Harahap

PATIENT IDENTITY

Name
: Kid. AS
Gender
: Male
Age
: 11 years old
Religion
: Moslem
Address
: Andi Tonro
Sungguminasa
Job
: Student
Admission date : 07/07/2012
Medical record no: 153259

History Taking
Chief Complaint: Erythema, bulla,erosion and crust in
Regio Labialis and regio truncus of Extremity superior
et inferior
Brief anemnesis: since 10 days ago the early lesion
in labial region and throughout the body. lesions in the
form bulla become pustule then broken into the crust.
Edema (-), pain (+), Itchy (+), febris (-), cough (-),
Dyspneu (-), vomitting (-), nausea (-), history of fever
and cough a 5 days ago (+)circumcision appeared 3
days before the complaint
family history with the same disease (-), history of
allergy (-), history of medication : the patient had
consumed drugs given after circumcision but his
family does not remember the drugs.

CURRENT STATUS

Consciousness
: Compos Mentis
General Condition : Moderate
Hygiene
: Moderate
Nutrition
: less
Vital sign
:
BP
: 100/60 mmHg
Pulse
: 98x/minutes
RR
: 20x/minutes
Temperature : 36,60C

DERMATO-VENEROLOGY
STATUS
Regio : Regio Labialis and regio
truncus of Extremity superior et
inferior
Ef
: Erythema, bulla,erosion
and crust

PHYSICAL
EXAMINATION
Anemic (-), icterus (-), cyanoses
(-)
Cor/ Pulmonal: Normal
Abdomen: Normal, peristaltic
(+)
Extremities: Edema (-)
Lymph nodes: Enlargement (-)

Laboratory Result

WBC
: 10.4 (10 3 /uL)
RBC
: 4,4 6 /uL)
HB
: 10,9 (g/dL)
HCT
: 34,9 (%)
PLT
: 488(10 3 /uL)
LYM
: 13,3 (%)
Creatine
: - mg/dl
GDS
: - mg/dl

RESUME
Kid.AS came to hospital with Erythema, bulla,erosion
and crust in Regio Labialis and regio truncus of
Extremity superior et inferior. Edema (-), pain (+), Itchy
(-), febris (-), cough (-), Dyspneu (-), vomitting (-),
nausea (-), history of fever and cough a 5 days ago
(+)circumcision appeared 3 days before the complaint
History of medication : had consumed drugs given after
circumcision but his family does not remember the
drugs.
Physical examination: Moderate
Dermato-venerology
Regio : Regio Labialis and regio truncus of Extremity
superior et inferior
Ef : Erythema, bulla,erosion and crust

DIAGNOSIS
Stevens-Johnson
Syndrome

DISCUSSION
SJS
acute
life-threatening
mucocutaneous
reaction
characterized by extensive necrosis
and detachment of the epidermis.
SJS severe variants of an identical
pathologic process and differ only
in the percentage of body surface
involved. Either idiopathic or druginduced.
Pathomechanism
is
widespread
apoptosis
of

DISCUSSION
Confluent erythematous purpuric and target-like
macules evolve into flaccid blisters and epidermal
detachment mostly on the trunk and extremities,
and there is associated mucous membrane
involvement.
Clinical manifestation are abnormalities in the
skin, mucous membranes
abnormalities in
orificium, and eye abnormalities. Treatment is
symptomatic.
Systemic
treatment
with
glucocorticoids
and
high-dose
intravenous
immunoglobulin is controversial

RECOMMENDED
EXAMINATION
Laboratorium examination
Histopathologically:

full-thickness

necrosis of the epidermis and a

sparse lymphocytic infiltrate.

TREATMENT &
MANAGEMENT
Dexametasone 0,5

mg3x1/day
Interhistin syrup 2x1 cth/ day
Curvit syrup 2x1 cth/day
Fuson cream 5gr

PROGNOSIS
Depends on rapid and right handling,
the
patient's
condition,
and
distribution of the lesion.

Thank
You