Chronic diabetic, with renal failure presented with Steven-Johnson syndrome over an epidermal area of 10%. What are alternatives of management of the case apart from steroids, and what role could biologic dressings play?
If your patient has renal failure, mainly related to diabetes, avoid the use of IV Ig that may worsen the renal failure. As the BSA involved is low, the main treatment is symptomatic, with regular antiseptics, dressing focused on help to epidermisation. Systemic steroids are not useful.
As a rule SJS is a result of medical drugs, so any presumptive drugs should be avoided. You can use biological dressings, but try also different thermal waters to spray over the body (for example Avene thermal water), even on the mucouse surfaces. Your patient will be thankful.
Thank you for the contribution. i had put my patient only on paraffin based dressings, and had some good rsults. as you had suggested the nephroogist did not advice immunoglobulins, as far as avene thermal water is concerned i have tried but not got an success in getting the contact to procure the water.
th patient is fine except that his sugar is not under control. he is off steroids.
his scrotum is badly invoved and finidng a suitable dressing for scrotum is difficult
Dear Ali,
It is really a very useful and interesting link. Thank you for the information included.
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