Reações cutâneas graves: uma visão abrangente sobre a síndrome de Stevens-Johnson, sua etiologia, fisiopatologia e abordagens terapêuticas

Stevens-Johnson Syndrome (SJS) is a rare and severe condition characterized by epidermal detachment and mucosal lesions, primarily affecting the mouth, eyes, and genitals. Often triggered by adverse drug reactions, such as antibiotics and anticonvulsants, SJS can also be caused by viral infections and, rarely, neoplasms. SJS forms a spectrum with Toxic Epidermal Necrolysis (TEN), differing in the extent of skin involvement: in SJS, less than 10% of the body surface is affected, while in TEN, the involvement exceeds 30%. Although rare, with an incidence of 1.2 to 6 cases per million people, SJS carries high morbidity and mortality, leading to complications such as severe infections and permanent damage to the skin and mucous membranes. Early diagnosis is crucial, based on characteristic lesions and a recent history of medication use. In some cases, a biopsy is necessary to confirm the diagnosis. Treatment involves a multidisciplinary approach, including intensive care, immediate discontinuation of the causative drug, and immune modulation with corticosteroids or intravenous immunoglobulin. While new therapies, such as cyclosporine and special wound dressings, are being explored, there is still a need for consensus on the ideal treatment protocol, as well as advances in personalized diagnosis and treatment.