Stevens-Johnson Syndrome: A Severe Mucocutaneous Emergency

Stevens-Johnson Syndrome: A Severe Mucocutaneous Emergency

Question 1. Write a short note on Stevens-Johnson syndrome.

“Factors influencing success with Stevens-Johnson syndrome treatment: Q&A”

Answer. Steven­Johnson syndrome is a severe bullous form of erythema multiforme with widespread involvement typically including skin, oral cavity, eyes, and genitalia.

• Skin lesions: The cutaneous lesions in this mucocutaneous ocular disease are those of erythema multiforme, although they are commonly hemorrhagic and are often vesicular or bullous.
• Oral mucous membrane lesions: Lesions are extremely painful and severe.
  Mucosal vesicles or bullae occur, which rupture and leave surfaces covered with white or yellow exudates.
  Erosions of the pharynx are common. Lips may exhibit ulceration with bloody crusting and be painful.
• Eye lesions: It consists of photophobia, conjunctivitis, corneal ulceration, and panophthalmitis. Blindness may result.
• Genital lesions: There is non-specific urethritis, balanitis, vaginal ulcers.

“Understanding Stevens-Johnson syndrome through FAQs: Q&A explained”

Question 2. Describe briefly Tzanck cells.

Answer. Tzanck cell is a term given to a free-floating epithelial cell in any intraepithelial vesicle.

Tzanck cells are seen mainly in two diseases, i.e.
1. Pemphigus vulgaris
2. Herpes simplex infection

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Tzanck Cells In Pemphigus Vulgaris

Pemphigus consists of vesicle or bulla formation in the spinous layer of epithelium just above the basal cell layer which leads to suprabasilar split.

Prevesicular edema weakens intercellular junctions and intercellular bridges between epithelial cells break and the epithelial cells fell apart which is known as acantholysis. Due to this clumps of epithelial cells found free on the vesicular space.

These loose cells are characterized by degenerative changes such as hyperchromatic staining and swelling of nuclei, cells become round, and these cells are known as tznck cells.

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Tzanck Cells In Herpes Simplex Infection

Herpes simplex virus mainly affects the epithelial cells. Infected epithelial cells undergo ballooning degeneration and show following features such as acantholysis, nuclear clearing, and enlargement of nucleus.

These acantholytic epithelial cells are known as tznck cells.