Study Shows Stevens-Johnson Syndrome Worse for Diabetics

Each year in the U.S., as many as two million people are diagnosed with Stevens-Johnson syndrome (SJS), a painful and dangerous skin disorder. Extensive research has shown that over-the-counter and prescription medications for pain, inflammation, mental illnesses, seizures, and infections typically trigger SJS. For example, studies of allopurinol, a drug that treats gout and kidney stones, have demonstrated a clear association between the prevalence of the skin condition among patients who use the medication.

Understanding how the disease presents in individuals with different comorbidities and specific risk factors has been the focus of much research over the past few decades. Now, another study has drawn a notable conclusion: diabetics with SJS experience worse outcomes.

The research results published in May 2023 examined the impact and severity of Stevens-Johnson syndrome on those who had certain health conditions, including diabetes mellitus. The study compared the risk of pneumonia, sepsis, and endotracheal intubation among four groups of patients, and those with diabetes faced greater risks of serious health effects than others.

There were 8,962 patients in the study, and 1,186 had diabetes mellitus. SJS patients who were diabetic had a mortality rate 14.3% higher, pneumonia rate 7.6% higher, sepsis rate 4.7% higher, and an endotracheal intubation rate 1.9% higher than the patients without any comorbidities. They also had a higher mortality and sepsis rate than the patients with obesity and tobacco users.

The results of this study showed that diabetes mellitus is associated with worse outcomes for people with SJS and related diseases, including toxic epidermal necrolysis (TEN). Given the mortality rate and possible health complications, the connection between the condition, medications and dosages, and comorbidities continues to be examined.

What is Stevens-Johnson Syndrome?

Stevens-Johnson syndrome is a disorder that affects the skin and mucous membranes. In its early stages, SJS presents as a mild flu, but it can quickly – and dangerously – develop into a severe and life-threatening condition.

After symptoms like fatigue, sore throat, and fever, SJS causes a painful rash that spreads, then blisters, leaving wounds that are extremely painful and susceptible to infection. The top layer of affected skin dies and starts to heal, but it can take weeks or months to recover. Mucous membranes in the eyes, genitalia, and mouth can also be affected, leaving blisters in these sensitive areas.

If caught on time, SJS can be treated, and patients have a good chance of recovering. However, the condition can develop into a related but more serious disease, toxic epidermal necrolysis (TEN), if untreated, mistreated, or undiagnosed; TEN occurs when 30% of the skin’s surface is affected, and the risk of death sharply rises.

It’s crucial for anyone who displays symptoms of SJS to seek medical attention immediately. Given the seriousness of the condition, SJS typically requires hospitalization. Doctors aim to reduce pain and treat wounds, allowing the skin to heal in a controlled environment. They also focus on determining what caused it, such as common medications linked to Stevens-Johnson syndrome.

SJS Risk Factors and Complications

According to the National Library of Medicine, medication causes SJS in over 80% of cases. The drugs that commonly cause the condition and related diseases include anticonvulsants, allopurinol, sulfonamides, antibiotics, nevirapine, nonsteroidal anti-inflammatory drugs (NSAIDs), and contrast media.

Stevens-Johnson syndrome may be rare, but there are dangerous health risks. Understanding the disease, who’s at risk, the possible complications, and what triggers it is important because of the high mortality rate.  

People with one or more of the following have an increased risk of developing SJS:

• Cancer
• HIV infection
• Weakened immune system
• History or family history of SJS
• Genetic factors, especially when medication is needed

Genetic factors linked to a greater risk of SJS include conditions requiring certain medications to treat, such as gout, seizures, and mental illnesses.

There are several complications associated with SJS and TEN, including sepsis (blood infection), respiratory failure, permanent skin damage, pneumonia, eye problems (mostly temporary, but can be permanent), and dehydration.

SJS and TEN deaths are mainly caused by sepsis or multiorgan failure. With recent research showing worse outcomes for SJS patients with diabetes, specifically, a higher rate of sepsis and other complications compared to others in the study, people with diabetes should know the signs and symptoms of SJS to best protect themselves.  

How an Attorney Can Help SJS Patients

Unfortunately, it’s estimated that medical malpractice causes more than 250,000 deaths in the U.S. each year. Doctors are responsible for providing a certain level of service and care to patients, from initial examination and support to recommending or prescribing medications, monitoring, and following up. When they don’t, they may be held liable.

Since SJS is most often triggered by a medication, there are several ways a doctor may fail in their duties to provide proper care to patients. This is why an attorney can help after a Stevens-Johnson syndrome diagnosis. If a doctor doesn’t do their job properly, it can negatively impact the patient, causing short- and long-term health issues and even death. Because of the dangers associated with failing to provide adequate patient care, a medical malpractice lawsuit may be the best course of action.

When it comes to SJS, doctors should inform patients of the risks associated with any drugs they prescribe or recommend, warn them of side effects, such as SJS, and what to look out for, and prescribe the proper dosage.

Once a patient has developed Stevens-Johnson syndrome, a misdiagnosis or failure to diagnose can have serious, even fatal, ramifications. Finally, doctors must also properly monitor patients. Otherwise, they may be held responsible for damages because of the many ways medical malpractice can cause Stevens-Johnson syndrome.

Beyond doctors, other parties may be held liable, such as pharmacists and drug manufacturers. Pharmacists must review medications with patients, give instructions for use, and inform them of the risks. Drug manufacturers may be negligent if they don’t warn consumers and doctors adequately.

Speaking with a Stevens-Johnson syndrome attorney after an SJS diagnosis is crucial to determine if you can seek compensation for medical costs, lost wages, pain and suffering, and more. And if a loved one died, the surviving family may be entitled to compensation if a doctor could and should have done more. If you developed SJS or TEN or a family member died from the disease, consult an experienced SJS lawyer to discuss your case.