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Stevens-Johnson Syndrome With Supraglottic Laryngeal Obstruction

Stevens-Johnson Syndrome With Supraglottic Laryngeal Obstruction Abstract • Patients with the Stevens-Johnson syndrome or erythema multiforme exudativum may present to the otolaryngologist because of involvement of the mucosa of the upper aerodigestive tract. Stevens-Johnson syndrome is a symptom complex of uncertain cause that affects the eyes, skin, and mucous membranes throughout the body. The epithelial lesions progress from macules to bullae that desquamate, form pseudomembranes, and finally heal. Generally there is a prodromal period with fever and symptoms of an upper respiratory tract infection. The literature related to the otolaryngologic manifestations of the disease is reviewed and a case of Stevens-Johnson syndrome with early involvement of the supraglottic larynx is presented. The otolaryngologist should be aware of this syndrome and should be prepared to manage the possible airway compromise. (Arch Otolaryngol Head Neck Surg. 1989;115:1381-1383) References 1. Stevens AM, Johnson FC. A new eruptive fever associated with stomatitis and ophthalmia . AJDC. 1922;24:526-533. 2. Von Hebra F. On Diseases of the Skin Including the Exanthemata . London, England: The New Sydenham Society; 1866;1:285. 3. Calcaterra TC, Strahan RW. Stevens Johnson syndrome oropharyngeal manifestations . Arch Otolaryngol Head Neck Surg. 1971; 93:37-41.Crossref 4. Nathan MD. Stevens-Johnson syndrome: twenty-three cases and their otolaryngologic significance . Laryngoscope . 1975;85:1718-1723.Crossref 5. Elias PM, Fritsch PO. Erythema multiforme . In: Fitzpatrick TB, Eizen AZ, Wolff K, Friedbars IM, Austen KF, eds. Dermatology in General Medicine . New York, NY: McGraw-Hill International Book Co; 1979;295-302. 6. Stein MR, Thompson CK, Sawicki JE, Martel AJ. Esophageal stricture complicating Stevens-Johnson syndrome . Am J Gastroenterol . 1974;62:435-439. 7. Wooten JW, Katz HI, Hoffman S, Link JF. Development of oral lesions on erythema multiforme exudativum . Oral Surg. 1967;24:808-816.Crossref 8. Shklar G. Oral lesions of erythema multiforme. Arch Dermatol. 1965;92:495-500.Crossref 9. Araujo OE, Flowers FP. Stevens-Johnson syndrome . J Emerg Med. 1984;2:129-135.Crossref 10. Howard JC, Wible LE. Oropharyngeal manifestations of erythema multiforme . Ann Otol Rhinol Laryngol . 1946;55:146-151. 11. Keil H. Erythema multiforme exudativum (Hebra): a clinical entity associated with systemic features . Ann Intern Med. 1940;14:449-494.Crossref 12. Alexander MK, Cope S. Erythema multiforme exudativum major . J Pathol Bacteriol . 1954;68:373-379.Crossref 13. Soll SN. Eruptive fever with involvement of the respiratory tract, conjunctivitis, stomatitis, and balanitis . Arch Intern Med. 1947;79:475-500.Crossref 14. Bond WR, Herrod HG, Duberstein LE. Hereditary angioedema: association with IgA deficiency and otolaryngologic disorders . Laryngoscope . 1981;91:416-421.Crossref 15. Purett CW, Kornblut AD, Brickman C, Laliner MA, Frank MD. Management of the airway in patients with angioedema . Laryngoscope . 1983;93:749-754. 16. Ashby DW, Lazar T. Erythema multiforme exudation major (Stevens-Johnson syndrome) . Lancet. 1951;1:1091-1095.Crossref 17. Genieser NB, Becker MH, Rothman J. Mediastinal emphysema complicating Stevens-Johnson syndrome . Arch Dermatol. 1972;105:421-433.Crossref 18. Friedman JH, Challenor Y, Brust JCM. Bilateral facial palsy associated with Stevens-Johnson syndrome . Neurology . 1979;29:1304-1306.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Stevens-Johnson Syndrome With Supraglottic Laryngeal Obstruction

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Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1989.01860350115026
Publisher site
See Article on Publisher Site

Abstract

Abstract • Patients with the Stevens-Johnson syndrome or erythema multiforme exudativum may present to the otolaryngologist because of involvement of the mucosa of the upper aerodigestive tract. Stevens-Johnson syndrome is a symptom complex of uncertain cause that affects the eyes, skin, and mucous membranes throughout the body. The epithelial lesions progress from macules to bullae that desquamate, form pseudomembranes, and finally heal. Generally there is a prodromal period with fever and symptoms of an upper respiratory tract infection. The literature related to the otolaryngologic manifestations of the disease is reviewed and a case of Stevens-Johnson syndrome with early involvement of the supraglottic larynx is presented. The otolaryngologist should be aware of this syndrome and should be prepared to manage the possible airway compromise. (Arch Otolaryngol Head Neck Surg. 1989;115:1381-1383) References 1. Stevens AM, Johnson FC. A new eruptive fever associated with stomatitis and ophthalmia . AJDC. 1922;24:526-533. 2. Von Hebra F. On Diseases of the Skin Including the Exanthemata . London, England: The New Sydenham Society; 1866;1:285. 3. Calcaterra TC, Strahan RW. Stevens Johnson syndrome oropharyngeal manifestations . Arch Otolaryngol Head Neck Surg. 1971; 93:37-41.Crossref 4. Nathan MD. Stevens-Johnson syndrome: twenty-three cases and their otolaryngologic significance . Laryngoscope . 1975;85:1718-1723.Crossref 5. Elias PM, Fritsch PO. Erythema multiforme . In: Fitzpatrick TB, Eizen AZ, Wolff K, Friedbars IM, Austen KF, eds. Dermatology in General Medicine . New York, NY: McGraw-Hill International Book Co; 1979;295-302. 6. Stein MR, Thompson CK, Sawicki JE, Martel AJ. Esophageal stricture complicating Stevens-Johnson syndrome . Am J Gastroenterol . 1974;62:435-439. 7. Wooten JW, Katz HI, Hoffman S, Link JF. Development of oral lesions on erythema multiforme exudativum . Oral Surg. 1967;24:808-816.Crossref 8. Shklar G. Oral lesions of erythema multiforme. Arch Dermatol. 1965;92:495-500.Crossref 9. Araujo OE, Flowers FP. Stevens-Johnson syndrome . J Emerg Med. 1984;2:129-135.Crossref 10. Howard JC, Wible LE. Oropharyngeal manifestations of erythema multiforme . Ann Otol Rhinol Laryngol . 1946;55:146-151. 11. Keil H. Erythema multiforme exudativum (Hebra): a clinical entity associated with systemic features . Ann Intern Med. 1940;14:449-494.Crossref 12. Alexander MK, Cope S. Erythema multiforme exudativum major . J Pathol Bacteriol . 1954;68:373-379.Crossref 13. Soll SN. Eruptive fever with involvement of the respiratory tract, conjunctivitis, stomatitis, and balanitis . Arch Intern Med. 1947;79:475-500.Crossref 14. Bond WR, Herrod HG, Duberstein LE. Hereditary angioedema: association with IgA deficiency and otolaryngologic disorders . Laryngoscope . 1981;91:416-421.Crossref 15. Purett CW, Kornblut AD, Brickman C, Laliner MA, Frank MD. Management of the airway in patients with angioedema . Laryngoscope . 1983;93:749-754. 16. Ashby DW, Lazar T. Erythema multiforme exudation major (Stevens-Johnson syndrome) . Lancet. 1951;1:1091-1095.Crossref 17. Genieser NB, Becker MH, Rothman J. Mediastinal emphysema complicating Stevens-Johnson syndrome . Arch Dermatol. 1972;105:421-433.Crossref 18. Friedman JH, Challenor Y, Brust JCM. Bilateral facial palsy associated with Stevens-Johnson syndrome . Neurology . 1979;29:1304-1306.Crossref

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Nov 1, 1989

References