Treatment of Stevens-Johnson

The Stevens-Johnson syndrome is a severe, sometimes fatal, bullous erythema, which affects the integument, conjunctiva, oral mucosa, nasal, vesico-urethral, gastrointestinal tract and breathing through erythematosus macules, blisters and sero-hemorrhagic purple incidence abruptly, causing cases of necrosis, often with causes unknown. Patients with this syndrome require intensive care, has a lot of pain every manipulation, have a large loss of fluids due to discontinuity of the skin, is highly susceptible to poisoning. . The scars resulting necrosis may lead to loss of bodily functions. When it reaches the bronchi, can lead to respiratory failure.
Goal: Reduce number of dressing changes to promote comfort and healing the skin. Case report: A female patient, 29 years old, white, married, smoking, depressive disorder, epilepsy treatment for 8 years with carbamazepine 200mg 2x a day. Diagnosis of Stevens-Johnson. Started with oral mucosal lesions in the ocular 19/09/2009, carbamazepine being interrupted and replaced by benzodiazepine. Referred to ICU days 25/09/2009, with bullous lesions all over the body and respiratory infection. On 02/10/2009 initiated the use of silicone screen the sites of rupture of the bubbles, leaving the entire body mummified with bandages (daily change). In 07/10, replaced the traditional curative for a foam covering the inner layer of silicone and high transfer capacity of exudate (exchange every 7 days) objective of reducing the trade, better pain management and decreased risk of infection. 6 days had elapsed epithelialization of the skin, leaving two bloody areas on the thighs, where he followed the screen using silicone. Conclusion: The use of foam covering and silicone acted positively in the treatment of lesions of Stevens-Johnson syndrome, reducing pain and healing time of injuries. The patient was discharged from ICU on 23/10/09.