Stephens – Johnsons Syndrome and Toxic Epidermal Necrolysis, Article Critique Example

Introduction

To deal with Stephens- Johnsons Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), a system that prevent colonization and infection of the wound has to be developed. The focus is to estimate the percentage of skin loss and develop a system of caring for the wound. This system promotes faster healing and facilitating care by staff (Jesitus, 2011, p.38). Before anything done to a patient, the percentage of the total body surface area affected assessed. If the percentage exceeds 30%, the dressing changes are required. This includes the institution of hydrotherapy with the help of the burn dressing team. However, if the surface area is less than 30% then the WOC nurses write orders for staff nurses to supply, apply, and change the dressing. This paper studies treatment of three patients with SJS and TEN conditions.

Cases

In case one, a 54-year-old man with a swelling on face, hands, and bumps on his palms, is given oral antibiotics and steroids and sent home. After three days, he worsened, with rashes, mucosal lesions, and a temperature of 102.7oF. Assessments revealed that the rashes were severe accompanied by bulla, macules, oral genital and periocular involvement causing confusion and severe pain. The dermatologist discovered it to be Stephens- Johnsons Syndrome (SJS) /TEN.

The second case involved 55-year-old woman suspected of bacterial meningitis. After being treated with two antibiotics, a skin lesion around her mouth developed and again she treated for herpes simplex virus with acyclovir (Chen et al, 2003, p.490). She later had nausea, vomiting, abdominal pains, and acute renal failure after several wrong diagnosis treatments. She had Stephens- Johnsons Syndrome (SJS) /TEN after a dermatologist assessed her.

The third case of a 47-year-old white woman with a burning rash on her chest administered to a steroids injection and discharged (Ferrándiz, 2001, p.1157). She later worsened and discovered with SJS/TEN. In conclusion, patients with skin disorders are tested for SJS/TEN before being administered for any other treatment.

References

Chen, K.T., Twu, S.J.,Chang, H.J. & Lin RS .(2003) American Journal of Public Health, Vol. 93 ( 3), pp. 489-492.

Ferrándiz P. C. García, F. D. ,Domínguez ,S. P. García, V.(2001). Journal of the European Academy of Dermatology & Venereology, Vol. 25 (10), pp.1153-1159.

Jesitus, J. (2011), Dermatology Times, Vol. 32 (2), pp.38-39.