Abstract
Steven Johnson syndrome is a rare, acute and fatal skin reaction involving mucus membrane. The most common causative factor among 80% of the population is allergic reaction to medications. It is also known as a "minor form of toxic epidermal necrolysis", in which skin cells die and epidermis gets separated from dermis. The skin usually regrows over weeks and full recovery takes months. This syndrome is a medical emergency condition which needs hospitalization. It has significant morbidity and mortality. In this article we will know the detailed information regarding Steve Johnson syndrome and its management according to Ayurveda.
Introduction
Steven Johnson syndrome (SJS) is a serious skin disorder that causes rashes, blisters on skin and skin starts peeling off. These rashes are painful which spread and form blisters, the top layer of affected skin dies and heals after several days. With skin, mucus membrane is also involved which includes eyes, genitals, lower respiratory tract, nasal and mouth mucosa. Complications may occur in eyes like conjunctivitis and keratitis. SJS is an immune mediated complex disorder. Initially in the early stage, patients have fever and flu like symptoms and in later stage rashes and blisters occur. It is a hypersensitive skin reaction. SJS involves 10% of body surface area. Treatment focuses on removing the cause, managing pain and caring for wounds done. The more severe form of Steven Johnson Syndrome is Toxic Epidermal Necrolysis (TEN) as it involves 30% 0f body surface area. The mortality of this disease is 5-7%.
Symptoms Of Steven Johnson Syndrome
The typical prodromal symptoms of Steve Johnson Syndrome are as follows-
- Productive cough or thick purulent sputum
- Fever
- Sore throat and mouth
- Headache
- Malaise
- Arthralgia and fatigue
- Skin painful and burning sensation
- Skin lesions appear on oral mucosa, esophagus, pharynx, anus vagina and urethra.
- Ocular symptoms - Red eye, watering, dry eye, pain and itching, decreased vision, foreign body sensation, diplopia, and photophobia.
- Reduced ability to eat and drink.
Clinical Representation
The clinical presentation of Steve Johnson syndrome is as follows-
- The rashes began as macules which may later turn into pustules, vesicles or bullae
- Typical lesion of multiform
- The lesions become bullous and later ruptured
- Rashes can form anywhere on palms, soles or dorsum of hand (extensor surfaces are commonly affected)
- Sloughing of skin
- Tachycardia
- Hypotension
- Seizures and mental illness
Causes Of Steven Johnson Syndrome
There are various etiological factors of SJS, whereas drugs are most common cause-
- Infections (viral diseases, influenza, herpes, mumps, typhoid, fungal diseases)
- Drug induced (antibiotics, analgesics, NSAIDS, cold and cough medications, penicillin's, anticonvulsant drugs)
- Genetics
- Idiopathic cause 25 - 50%
Risk Factors
The risk factors regarding SJS are as follows-
- Family history
- Weak immune system
- Genetics
- HIV infections
- H/O having medications
Diagnosis
The diagnoses of Steve Johnson syndrome are as follows-
- Darshan, prashan and sparshan (physical examination and medical history)
- Skin biopsy
- Culture
- Imaging
- Blood tests
Ayurvedic View Of Steven Johnson Syndrome
It is a misconception that natural herbs cause no risk but some drugs cause adverse reactions such as guggul, swarna bhasma, rasa aushdhis, etc. If drugs are taken without proper knowledge, over dosage and their principles. Reactions can also be caused by having the wrong species of medicinal plants. According to Ayurveda. Balancing doshas (vata, pitta and kapha) are done and detoxifies the body helps in recovery of Steve Johnson syndrome. Diet based on raw and healthy foods including fresh fruits, juices and vegetables added with plenty of water is recommended during treatment.
Management
Primarily, as we know SJS is an emergency condition, the patient should be hospitalized and stop the medications which the patient is taking to rule out the cause, then manage accordingly.
- Stopping non-essential medications
- Antibiotics to control infection
- Pain medication to reduce discomfort
- Anti- inflammatory drugs or ointments. Corticosteroids and immunoglobulins
- Supportive care - Fluid replacement, nutrition, wound care, etc
Herbal Treatment By Planet Ayurveda For Steven Johnson Syndrome
Planet Ayurveda is a widespread company which is known for its natural and raw products and it is also GMP certified. Planet Ayurveda has various combinations of medicines for different disorders. All the products are natural without any artificial preservative. The best herbal combination for Steven Johnson Syndrome by Planet Ayurveda are as follows are as follows are as follows-
- Kaishore Guggul
- Gandhak Rasayan
- Manjishtha Capsules
- Gleaming Skin, Hair, Nails Formula
- Chopchini Churna
Products Description
1. Kaishore Guggul
Kaishore Guggul is a vati preparation mentioned in Ayurveda classical texts. It mainly contains two ingredients triphala - Amalaki (Phyllanthus emblica), haritaki (Terminalia chebula) and bibhitaki (Terminalia billerica) and guggul (Comiphora mukul). These tablets help in blood circulation and act as a defense mechanism. It has anti- inflammatory, anti – bacterial properties and is used in metabolic disorders. It reduces pain and swelling.
Doasge: Two tablets twice a day after meals.
2. Gandhak Rasayan
The gandhak rasayan is standardized tablet preparation which contains gandhak (sulfur), it has a wide range of therapeutic and rejuvenating properties. It increases immunity and protects against many infectious diseases. It has antibacterial properties and cures various skin disorders.
Dosage: Two tablets are given twice daily with lukewarm water after meals.
3. Manjistha Capsules
Manjistha Capsules are standardized preparations which mainly contain manjistha known as Rubia cordifolia. It acts as blood purifier (Rakta shodhak) and is useful in skin rashes, acne, itching, irritation, scales and patches. The anthraquinones present in manjistha possess its anti microbial, anti fungal, antioxidant property and act as immuno- modulator.
Dosage: One is given twice daily with lukewarm water after meals.
4. Gleaming Skin, Hair, Nails Formula
It is a capsule preparation which contains manjistha (Rubia cordifolia), pit papda (Fumaria officinalis), sariva (Hemidesmus indicus). Manjistha acts as a good blood purifier and helpful in skin disorders. Fumaria is useful in treatment of different dermatological conditions, eruptive skin diseases such as eczema, multiple sclerosis, psoriasis because it contains alkaloids, tannins. Hemidesmus is widely used for skin diseases and helps in detoxifying the body.
Dosage: 1-2 capsules twice daily with plane water after meals.
5. Chopchini Churna
Chopchini churna is a powder preparation in classical Ayurveda. It mainly contains chopchini (Smilax china). It has analgesic, anti-inflammatory and stimulant effects. It is a very beneficial herb for various skin disorders. Chopchini balances all tridosha (vata, pitta, kapha).
Dosage: ½ tablespoon twice daily with lukewarm water after meals.
Conclusion
Steven Johnson Syndrome is a life threatening mucocutaneous disease triggered by medications mostly and some viral diseases. All the information mentioned above can be helpful if somebody is suffering Steven Johnson Syndrome but for medicinal advice you must concern the physician. The team of Planet Ayurveda is experienced to help you in recovering from diseases.
