Postacute sequelae of Stevens-Johnson syndrome and toxic epidermal necrolysis
- Skin, hair, nails: Hyper- and hypopigmentation that may be permanent and abnormal scarring, including hypertrophic scars and keloids. Xerosis, pruritus, chronic eczema, eruptive melanocytic nevi, and telogen effluvium have been reported. A variety of nail changes have also been reported, occurring in up to 50% of patients, especially those who have experienced more severe disease. Onychomadesis or Beau lines are seen initially, depending on whether nail matrix arrest is complete or partial. Affected nails may manifest dystrophic changes as they regrow.
- Ocular: More common manifestations include conjunctivitis, dry eye syndrome, conjunctival membranes, or symblepharon formation. Less common signs are corneal scarring, corneal neovascularization, and trichiasis. Most severe signs include corneal ulceration, subconjunctival fibrosis, limbal stem cell failure, entropion, and corneal opacification leading to blindness.
- Nasal and oropharyngeal: Oral frenulum-like fibrotic bands, nasal septal synechiae, sicca syndrome (which may lead to reduced salivary flow and pH, periodontal disease, gingival inflammation, and oral discomfort), depapillation of the tongue, and severe oral fibrosis resulting in difficulty eating and speaking.
- Pulmonary: Chronic bronchitis, bronchiectasis, bronchiolitis obliterans, bronchiolitis obliterans organizing pneumonia, and respiratory tract obstruction have all been reported in the postacute phase.
- Genitourinary: Vulvovaginal synechiae or stenosis, dyspareunia, phimosis, and genitourinary strictures.
- Gastrointestinal: Esophageal strictures, ileal ulcers.
- Psychological: Anxiety, depression, and posttraumatic stress disorder.
L51.1 – Stevens-Johnson syndrome
L51.2 – Toxic epidermal necrolysis [Lyell]
768946000 – Stevens-Johnson syndrome, toxic epidermal necrolysis spectrum
- Intrinsic atopic dermatitis