Talk:Stevens–Johnson syndrome

A misplaced or spam link
Under external links there is one with the text "Book On Stevens Johnson Syndrome - Best On The Market" that points to http://waboyer.com/ That sight has a link on the side about Stevens-Johnson but is a collection of someone's writings about all kinds of subjects.The S-J book is not a book, it is an advertisement for a book. I'm not up on wikipedia policy but I'm pretty sure this is self-promotion and close to being spam.75.163.96.162 (talk) 11:11, 7 July 2009 (UTC)

Eponyms
Why is it called Stevens-Johnson syndrome? Were those two doctors who discovered it? Or were they patients who had the symptoms? — Preceding unsigned comment added by 75.74.113.1 (talk) 23:00, 25 November 2006 (UTC)

They were the doctors - I've added clarification in the Eponym section SJFriedl (talk) 16:09, 19 January 2008 (UTC)

Ginseng
Where is the source or note suggesting SJS is associated with gigseng? —The preceding unsigned comment was added by 206.170.104.39 (talk) 20:31, 16 December 2006 (UTC).

The final paragraph listed under the treatment section must be aa hoax. It makes no sense whatsoever. Putting a tooth into someone's eye to restore sight? Is someone pranking this entry? Saamiheart 15:38, 2 October 2007 (UTC)saamiheart

Dear editors, I'm Amalyste's projet manager in France, a French SJS & TEN patient association. You may find our website by typing AMALYSTE

I'd like to correct your definition because most cases are not in fact idiopathic but iatrogenic (that is caused by specific drugs) and a very small minority are caused by bacteria or viruses (lung mycoplasms as well). So please review this information. Likewise, the odonto-kerato-prothesis (the tooth based prothesis) is not an hoax but really a last resort solution for the most dramatic ocular sequelea caused by both syndromes (SJS and TEN).

If you allow me to correct this I will, but I'd rather see you do it. I once corrected an article that was once considered as spam, orthewise I could add the references you need to confirm both statements.

Let me know, best regards Association AMALYSTE —Preceding unsigned comment added by 82.243.246.224 (talk) 12:50, 10 June 2008 (UTC)

Don't forget TENs association with Bactrim. — Preceding unsigned comment added by 137.54.66.129 (talk) 23:07, 7 April 2013 (UTC)

"People with S-J"
The section "People with Stevens-Johnson Syndrome" should probably not include any names without a reference - though I was able to find (and add) the reference for Tessa Keller, I couldn't find anything for Sebastian Tamayo, Donald Trump's assistant. Should this name be removed pending a reference? SJFriedl (talk) 16:01, 19 January 2008 (UTC)

gout medication links to stevens-johnson syndrome
There is a case in south central Indiana where an 85 year old male who had been taking medication for gout contracted Stevens-Johnson Syndrome. Recovery is slow and on going. Looking at a lengthy hospital stay. THe medication was allpurniol. —Preceding unsigned comment added by 76.251.80.204 (talk) 02:53, 28 August 2008 (UTC)

nevirapine
may also cause SJ it is a Non-nucleoside reverse transciptase inhibitor. Should be inserted and referenced. AriaNo11 (talk) 03:43, 17 October 2008 (UTC)

picture request
I'm 12 and I've had Stevens Johnsons Syndrome, I think a picture would improve the quality of this page and I don't think there's any point in the 'who's had SJS'SophieLaura96 (talk) 19:28, 12 March 2009 (UTC)

requested citations
I have a friend suffering from this disease right now. When I was trying to find out what this is, I noticed in the "Treatment" section "citation requested" that the text is exactly the same as at this URL under "treatment": http://www.sjsinfo.net/ —Preceding unsigned comment added by 86.60.209.83 (talk) 18:10, 9 June 2009 (UTC) hay im melissa hoffin from northwest coast of scotland and is currently in a hospital bed right now at crosshouse hospital with stevens johnson syndrome and only 20 years old im lookin pretty bad at the moment and on so many different antibiotics and drips to get me back to health at first when i came to hospital i looked like something from a horror movie, extremely red sticky eyes like the zombies from resident evil (great movies by the way), nose bleads, sore chesty cough, couldnt speak, slevering (alot), mouth ulcers, swollen throat and toung, unsteady and run down, ect you get the hint as some of you have this or know someone who has.but when i got here i just brought up all my liquid medication they tried tablets and things but couldnt bring myself to take the pain aw it was horrific my throat was so raw and sore and am now for my third time moving from ward to ward am in a room of my own its peiceful and when bein this ill its not very nice having an audience around you with all there different problems too.but i miss family so much being away from them took away my spirit and will to get better it dosnt help when i feel discusted with my own body and the people i care about most are not there to let me know things are gonna be ok as reasurance is good for the mind i suppose,but crosshouse hospital> ayr hospital>   all the rappid weight loss even though im thin enough im now 7stn, my skin is discoloured with medication and my mouth extremely hurts just now, nothing helping that atm but eyes are better my eye specialist was realy nice though haha but grateful and a lucky girl to have caught this is time i wont become blind. iv also stopped throwing up blood when your mouths as sore as this believe me when i say thank god the pain from bein sick i thot was alot more extreme but what kept me happy inside was my friends, family and visits everyday from the ones you love, my boyfriend thankfully dont look at me any different, im still his blonde haired blue eyed bimbo but i accordingly look ok and just cant wait to get better and pamper myself. and btw if you end up always sick be prepared as the jag on the bottom wasnt veeery nice haha. but im bein well looked after by all these people and the nurses are very nice i have my favourates lol no realy there all great they do alot of running around for me trieng there best and speak to me really nice its asif im not a patient that they have to look after because its there job and they make me feel like im making good progress, they make me feel like nothing matters and that, when i slever, have to show off un nessesary parts when am getting hooked to machines, when my breath stinks and i cant brush my teeth but they talk to you anyway, it makes things alot easier and theres people out there worse off, even though i could have died i didnt and theres people out there that have with this condition but theres someone watching over me, it makes me realise how fortunate i am and at first when i was told about what i had i thought i was gonna die but iv been touched by what i like to call the angle, but to those who have this i do hope in time you all get better, being in hospital having a near death experience has changed my perseption and the way i think and look at life, when i get out ill sure be making the most of my life and hope that this diease dosnt come back to haunt me as iv had a horrible experience i dont want to ever come across.but im gonna go now and try get some soup as the past little while i havent eaten and too be honest it shows but the more the progress the better the health. thankx for reading a little bit of the journey iv hed with sjs. — Preceding unsigned comment added by 89.206.182.27 (talk) 14:38, 20 May 2012 (UTC)

Symptoms?
Wouldn't a symptoms/presentation section be helpful?Peetiemd (talk) 02:32, 19 June 2009 (UTC)

if a chiled gets the syndrome do they have a better chance of dying? and how long dose it take to gert rid of it ? —Preceding unsigned comment added by 165.214.14.22 (talk) 19:36, 23 August 2010 (UTC)

Picture
I just came across this page from a fairly unrelated article, not kowing what SJ-Syndrome was and I was somewhat startled by getting an image of a body looking like it's in the process of decomposing flashed into my face without any warning whatsoever. I'm not a queasy person but I would think that someone of a less robust disposition might actually be disturbed by this. I'm not at home with editing the wiki, but I would suggest to at least move the picture down so that anyone coming across this article will read about the condition and be aware that pictures of necrolysis might be included.
 * I agree with this, could we remove it? --Knightdaemon (talk) 01:54, 6 December 2010 (UTC)


 * Moving the image below the fold would appease the OP, but it shouldn't be removed entirely. --Simpsora (talk) 01:29, 26 April 2011 (UTC)


 * Ah no I do not think we should move it. This is a serious medical condition. The image reinforces this fact. Doc James  (talk · contribs · email) 01:34, 26 April 2011 (UTC)


 * While I would agree that it's a very serious condition, it's also a very uncommon condition, and those looking at the page trying to learn and understand the disease, especially the young ones, should not need to see such a graphic and vile picture. Another note, I'm sure not all people who have this condition have such a bad case of it as this, I'd assume this to be a bit of an extreme case actually. What's wrong with showing someone who has a mild-moderate case of this illness so that those viewing this page are not disturbed?           aglo123 (talk) 20:04, 3 December 2012


 * Not sure if it's directly a matter of policy but usually there's a picture on the top right as part of the sidebar. Look for example at necrotizing fasciitis or gangrene, both of which have arguably shocking images in the prominent top right position. Also just because the image is shocking it shouldn't be removed as long as the image is relevant to the subject and helps the article. Also, per WP:NOT and massive precedent in articles pertaining to every subject. Cat-five - talk 19:43, 27 May 2011 (UTC)

Hi there. I agree to the notion that the picture is gruesome, but terrible diseases have to be pictured accordingly. But take heed of the fact that this disease is a disease which can occur when someone uses drugs against depressive, bipolar, epilectic or other disorders. But it's a uncommon, seldom adverse reaction. I think that there is a probality that people who suffer from depression etc. are hindered to take drugs against depression because of the picture. Taking into account that many people (me included) use wikipedia to inform themselves about medication. A huge improvement would be, if there was additional information why the pictured unfortunate suffers from SJS. Maybe the cause isn't related to the ordinary use of a drug, but he accidentaly overdosed. Or its because of an infection. Whatever the cause, it has, in my opionion, to be stated. Neither the article nor the source mentions the cause of the SJS of the pictured suffer. — Preceding unsigned comment added by 92.229.160.16 (talk) 23:08, 12 December 2011 (UTC)
 * Hello, while I personally agree that abusing prescription medications is unhealthy and wrong and needs to stop, it needs to be understood that the intentions of Wikipedia are not to convince, they are to inform. Therefore, by saying that the picture is beneficial in that it would convince readers not to abuse harmful drugs is completely counter-intuitive and causes a bias and an overall "black-eye," albeit a small one, on the image of Wikipedia. aglo123 (talk) 09:29, 6 March 2013

Could we make the picture smaller? It's creepy as hell, I nearly crapped myself.128.138.24.47 (talk) 06:43, 25 February 2012 (UTC)

I strongly agree with MOVING the picture, not removing it, and maybe even making it smaller; I'm 30 and I'm not easily scared or shocked, but I came to this article from Manute Bol's (who suffered from it), being in my office, and a dead man came on screen... Manute Bol looked just fine, so I imagined the syndrome was something not noticeable. I don't think that such graphical image is necessary to make or "reinforce" any kind of point, it looks like some sensationalist press, not Wikipedia. I agree it's something serious, the pic is useful, but it really doesn't need to be right there, flashing every incautious old lady, old man, woman, child, etc., who might access the article. I think the main issue is that it shows a face, a person, lying there... probably dead. Just censoring the eyes does absolutely nothing to avoid the normal shock reaction to many people. This is not a medical book, it's Wikipedia, even University teachers warn the medical students before showing corpses. Endymx (talk) 21:18, 24 February 2014 (UTC)


 * I think the picture should remain and probably in its current place. It is a photo which illustrates the subject of the article. It is regrettable that the image may be disturbing but WP is an encyclopedia and images which clearly illustrated the subject of an article should be prominently featured. I am fairly certain the image is not of a dead person, the appearance is not that of a corpse. The blanking of the eyes is most likely done for privacy concerns not for reducing the "shock reaction". Factual and accurate content should not be censored in the name of reader sensitivities. If there is policy on this it should be followed. The examples by Cat-five seem to support the current placement with precedent. - - MrBill3 (talk) 05:38, 25 February 2014 (UTC)

Okay, I almost never edit things on Wikipedia, and I first came across this article in January 2012. I was completely shocked and traumatised by this picture because I was on a medicine that has SJS as a side effect. After much panic and trauma conselling (literally!) my doctors assured me that the man in the picture is BEYOND the absolute worst scenario. I spoke to four different doctors, who were very acclimated to severe medical issues, both in real life and in pictures, and all four of them were appalled of the choice of image that is used here. And to give the argument that is given above, that this is an encyclopedia, not a family health website, I find the premise of the argument to be sound, but if a more realistic image would suffice, moreover, be preferable to this then why would the standards be different for Wikipedia? Virtually all cases are stopped before they can progress to this. First there are sores in the mouth, and then it progresses from there in increasing levels of severity. The man afflicted in the picture appears to be dead. This must have happened because there was no response to his condition and he kept taking whatever substance triggered the SJS. I simply CANNOT believe that this picture is still here three years later, after multiple requests to take it down! There are so many other pictures that I could supply that would more accurately reflect what SJS truly is, without resorting to using this picture. Please I am begging you, let me change the picture to something more appropriate. David B from Johannesburg105.236.98.148 (talk) 17:19, 3 July 2014 (UTC)
 * If you have photographs that will provide a better illustration for the article, upload them to the commons and provide a link here. - - MrBill3 (talk) 04:44, 12 July 2014 (UTC)


 * Disagree with removing the pictures. Pictures are key to understanding and recognizing the disease. BakerStMD T&#124;C 01:38, 15 January 2015 (UTC)
 * we should not use this picture (or any other identifiable living person) without direct confirmation of their assent to be pictured and identified as a person with SJ. Per WP:BLP -- TRPoD aka The Red Pen of Doom  03:16, 15 January 2015 (UTC)

three to six ratio
Umm why would you say three to six ratio when the obvious and correct way of saying it would be one to three ratio? —Preceding unsigned comment added by 208.110.226.193 (talk) 19:39, 16 November 2010 (UTC)


 * Uhm, 3 to 6 ratio is 1 to 2 ratio, not 1 to 3 like you wrote. 84.197.115.157 (talk) 08:06, 20 June 2011 (UTC)

Stevens-Johnson Syndrome UK
I am the mother of Calvin Lock, my son suffered from TENS due to an allergic reaction to Ibuprofen. I witnessed the illness unfold from the start and to this day, still cannot believe the failings of the health professionals responsible for my son's care and diagnosis. I know there is a massive difference between Stevens-Johnson Syndrome and Toxic Epidemal Necrolysis, especially incidence rates. The facts about 'rarity' are mis-leading. Stevens-Johnson Syndrome is in fact NOT rare. It affects 1 in every 5000-10000 people in the U.K every year. Toxic Epidemal Necrolysis IS rare. It affects 1 in every 1-3 million people in the U.K a year, as far as reported cases go. I would guess these are survivors and sadly, i believe that death related incidences go UN-REPORTED. There needs to be more accurate awareness of this illness across the medical profession. I personally feel that due to the high level of drug related reactions, the illness is somewhat being 'covered up'. Many sufferers are unaware of the U.K's YELLOW CARD SCHEME on the MHRA website. Here you can report your allergic reaction to the drug you were taking. Patients are never told about this. I WASN'T informed about this. I asked the hospital consultants if THEY had reported my son's adverse reaction, they HAD NOT!!! They're explanation- ' we do not report reactions to existing drugs, we only report reactions to NEW drugs'. I was fortunate enough to be informed by another victim about the reporting scheme, sadly, many are unaware. To date, there have been 8771 'reported' reactions to the drug IBUPROFEN, 4899 were ADVERSE REACTIONS. I run a support group for S.J.S & T.E.N.S victims. I have 2 people who suffered adverse reaction to Nurofen and their cases went un-reported. They are now in the process of doing so. How many more are out there???? I have read through many P.I.Ls from different brands of Ibuprofen and only a few clearly state S.J.S/T.E.N.S can occur as a very rare side effect. Many well known brands are aware their product can cause this adverse reaction, yet fail to disclose this information. I find it extremely worrying that on nearly every brand of a childs ibuprofen, there is no instruction that the product SHOULD NOT BE GIVEN TO A CHILD WITH CHICKEN POX.

Getting back to the awareness side of things, there is no patient information leaflet available on this illness. The public refer to the internet for advice and info and sadly read about the dramatic cases, view horrific images of the worst cases and are left in a state of panic and confusion. Victims react in many different ways, there are very few reports of the thousands of cases of EARLY DIAGNOSIS and recovery. For any sufferer, there is no AFTER CARE advice sheet/leaflet, no links to support groups or charities and no information on possible long term after effects.

Why is it kept so 'hidden'??? If you type the conditions into the N.H.S CHOICES website, there are NO results!! Its about time the medical profession got better educated so in turn, the general public had access to valid information. Awareness is more likely encourage the public to be a bit more vigilent when it comes to taking medicines, maybe even encourage them to read P.I.L.s ( if more simplified). Until then, horror stories are more likely to discourage people into using medicines and also, create bad press for victims of this illness. Robyne01 (talk) 09:44, 11 January 2013 (UTC)

I have been prescribed a course of co-amoxiclav antibiotic for an annoying but in no way life threatening urinary tract infection. The documentation provided with this drug includes a warning about the possibility of SJS & TEN with an unknown frequency. Having read the main SJS page there is no way I am going to use this drug; it seems utterly irresponsible to suggest its use in any condition which is not life threatening; so this page has deffo scared at least one reader off using a prescribed drug, and seeded an attitude of distrust for his medic ! AJS — Preceding unsigned comment added by 77.96.59.93 (talk) 19:04, 20 December 2013 (UTC)

Refs formatted, section paraphrased, work suggested
The references have been uniformly formatted.

Removed references
Reference removed from article, failed verification.

References at end of ref section not footnoted removed.

Stevan Johnson syndrome treatment s by medibird.com

35 J Rheumatol. 2003 Oct;30(10):2234-40. The risk of Stevens-Johnson syndrome and toxic epidermal necrolysis associated with nonsteroidal antiinflammatory drugs: a multinational perspective. Mockenhaupt M, Kelly JP, Kaufman D, Stern RS; SCAR Study Group. http://www.ncbi.nlm.nih.gov/pubmed?term=14528522/ pmid= 14528522

Infections subsection
The entire Infections subsection was a cut and paste. I did what I could to paraphrase and attribute it. The section needs a rework with multiple references.

Suggested reference
The article needs some work, cohesion, flow, structure, references.

- - MrBill3 (talk) 12:21, 25 February 2014 (UTC)

notable people
someone keeps adding a 17 year old UK girl. She is not notable in any way at all. Can you please stop adding her, just because she had it doesnt make her notable!!86.162.27.214 (talk) 10:47, 2 July 2014 (UTC)

SJS, TEN, EM
I think the difference between EM and SJS/TEN overlap (see e.g. Classification) needs some clarification 193.202.91.11 (talk) 08:02, 12 May 2017 (UTC)
 * EM no longer considered as part of the continuum per  Doc James  (talk · contribs · email) 17:11, 12 May 2017 (UTC)

SJS article NOT SCARS article
This content added to the first paragraph

"SCARS includes five syndromes: Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome), Acute generalized exanthematous pustulosis (AGEP), SJS; Toxic epidermal necrolysis (TEN), and Stevens-Johnson/toxic epidermal necrolysis overlap syndrome (SJS/TEN). Each of the five disorders is commonly initiated by medications but typically only in individuals who are genetically or otherwise predisposed to do so. The pathophysiology, i.e. mechanism(s), for these predispositions is incompletely understood. Nonetheless, new strategies are in use or development to identify those individuals who are predisposed to experience the SCARs-inducing effects of specific drugs and thereby avoid treatment with them. "

Belongs in the article on SCARS

Disorders are NOT combated but treated.

The lead typically follows the order or the body which it did before and which I have restored.

Have moved a brief overview of SCARS to paragraph 3. Best Doc James  (talk · contribs · email) 16:56, 14 March 2018 (UTC)

First sentence
Have restored the first sentence to:

"Stevens–Johnson syndrome (SJS) is a type of severe skin reaction."

This is easier to understand than

"Stevens–Johnson syndrome (SJS) is one type of a set of skin reactions termed severe cutaneous adverse reactions (i.e. SCARs)"

Also the first is supported by the reference provided. Doc James (talk · contribs · email) 17:14, 15 March 2018 (UTC)

Orphaned references in Stevens–Johnson syndrome
I check pages listed in Category:Pages with incorrect ref formatting to try to fix reference errors. One of the things I do is look for content for orphaned references in wikilinked articles. I have found content for some of Stevens–Johnson syndrome's orphans, the problem is that I found more than one version. I can't determine which (if any) is correct for this article, so I am asking for a sentient editor to look it over and copy the correct ref content into this article.

Reference named "pmid27154258": From Drug reaction with eosinophilia and systemic symptoms:  From Severe cutaneous adverse reactions:  

I apologize if any of the above are effectively identical; I am just a simple computer program, so I can't determine whether minor differences are significant or not. AnomieBOT ⚡ 15:47, 24 March 2018 (UTC)

Why is this paragraph in imperial units?
For some reason, despite this being a medical article, somebody used imperial units here (making it literally unreadable for majority of the human population):

Can this be corrected? As far as I remember, the general consensus on Wikipedia was to use metric units except in articles directly related to places that use imperial system (like articles about cities in the USA). Also, articles about science generally follow metric units strictly, especially when it comes to something as precise as diagnostics...

It would be probably best to just put metric units as primary and put imperial ones in parenthesis, that way it will still be convenient to everybody, while still respectful towards the scientific community.

Suggested additional content
Sequelae in former SJS/TENS survivors — Preceding unsigned comment added by PhiloMarx (talk • contribs) 04:35, 27 December 2020 (UTC)

"Stevens-Johnson-Fuchs-Syndrome" listed at Redirects for discussion
The redirect [//en.wikipedia.org/w/index.php?title=Stevens-Johnson-Fuchs-Syndrome&redirect=no Stevens-Johnson-Fuchs-Syndrome] has been listed at redirects for discussion to determine whether its use and function meets the redirect guidelines. Readers of this page are welcome to comment on this redirect at  until a consensus is reached. The Blade of the Northern Lights ( 話して下さい ) 23:23, 20 January 2024 (UTC)