Tuesday, July 25, 2017

Steven-Johnson syndrome (SJS) / Toxic epidermal necrolysis (TEN) -Part 2

Hello :)

Have you heard of SCORTEN SCORE?
It is a score used to assess the severity of illness in TEN.

Go to the link below:-



-We can assess the nutritional status by the body weight.
-Body is in the condition of hyper metabolism which will lead to excessive proteolysis.
-For the above thing, check albumin levels.
-Due to excessive fluid loss body will undergo dehydration and hypotension.
-Temperature should be noted. As each degree increase in temperature over normal, increases metabolism by 5-8%.
-Ocular examination is important part.
-Check for LFT and RFT.
-Late ophthalmic complications are mainly due to functional alteration of the conjunctival epithelium with dryness and abnormal lacrimal film. This leads to chronic inflammation, fibrosis, entropion, trichiasis, and symblepharon. Long-term irritation and deficiency of stem cells in the limbus may result in metaplasia of corneal epithelium with painful ulcerations, scarring, and altered vision.
- Esophageal, intestinal, urethral, and anal strictures may also develop in rare cases. 

Nutrition: -
 Consist 2 parts
1) parentral
2) Entral

Parentral nutrition consist of dextrose.
Entral is important for this patient.
-Protein powder.
-Dal.
-Fruits e.g. Banana

-We use various feeding devices like nasogastric tube or ryles tube.

Treatment:-

-Stop all the drugs
-airway breathing circulation fluids
-Symptomatic treatment

MEDICATIONS
Antibiotic to treat and prevent infections.
Used to treat and prevent severe skin inflammation.
Ranitidine reduces the acidity.
BETADINE MOUTH GARGLE: Oral antiseptic for relief of painful infections and inflammatory conditions of mouth and pharynx
Anti-inflammatory, Anti-pruritic, and Vaso-constructive properties. To cure mouth ulcers.

-Burns guideline (but lesser fluids)

That's all for today .
-Upasana Y. :)
x

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