Stevens–Johnson syndrome constitutes a dermatological emergency. Patients with documented Mycoplasma infections can be treated with oral macrolide or oral doxycycline. Initially, treatment is similar to that for patients with thermal burns, and continued care can only be supportive (e.g. intravenous fluids and nasogastric or parenteral feeding) and symptomatic (e.g., analgesic mouth rinse for mouth ulcer). Dermatologists and surgeons tend to disagree about whether the skin should be debrided. Beyond this kind of supportive care, no treatment for Stevens–Johnson syndrome is accepted.
Treatment with corticosteroids is controversial. Early retrospective studies suggested corticosteroids increased hospital stays and complication rates. No randomized trials of corticosteroids were conducted for Stevens–Johnson syndrome, and it can be managed successfully without them. Other agents have been used, including cyclophosphamide and cyclosporin, but none has exhibited much therapeutic success. Intravenous immunoglobulin treatment has shown some promise in reducing the length of the reaction and improving symptoms. Other common supportive measures include the use of topical pain an aesthetics and antiseptics, maintaining a warm environment, and intravenous analgesics. An ophthalmologist should be consulted immediately, as Stevens–Johnson syndrome frequently causes the formation of scar tissue inside the eyelids, leading to corneal vascularization, impaired vision, and a host of other ocular problems.
The majority were female (56.9%) and Chinese (90.9%) with mean age 66.1 ± 11.0 years. Intraoperative complications were subconjunctivalhemorrhage (290, 26.2%), anterior capsule tear (9 eyes, 0.81%), posterior capsule rupture (3 eyes, 0.27%), suction loss (5 eyes, 0.45%), iris hemorrhage (1 eye, 0.09%), and endothelial incision (1 eye, 0.09%). There was no dropped nucleus. Visual outcomes of 794 laser surgeries were compared to 420 controls. The %UAVA 20/25 or better was higher in laser cases (68.6% vs 56.3%; P < .0001) but MAE (0.30 ± 0.25 diopter [D] vs 0.33 ± 0.25; P = .062) and MSE (0.16 ± 0.27 D vs 0.17 ± 0.28 D; P = .065) were not significant.