DISCUSSION

Stevens-Johnson syndrome (SJS) is mucocutaneous drug-induced or idiopathic reaction patterns characterized by skin tenderness and erythematic of skin and mucosa, followed by extensive cutaneous and mucosal epidermal necrosis and sloughing !lmost any medication including over-the-counter drugs, such as "buprofen, can cause SJS
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"n this case, the rash on patient's body occurred gradually within $ days, after taking medication (e have found that patient had token NeuralginTM as his medicine in his medication history NeuralginTM it self consist of "buprofen $)) mg, which theorically leads people to SJS phenomenon *he clinical manifestation of SJS is +uite complicated *he distribution is initial erythema on face, extremities, becoming confluent over a few hours or days and widely distributed with prominent involvement of trunk and face ,)- of patients have mucosal lesions, i e , erythema, painful erosions. lips, buccal mucosa, con/unctiva, genital and anal skin and 01- have con/unctival lesions # "n *his case, the rash on patient's body occurred gradually starting first on his chest, then his mouth and face and genitalia in the following day 2yes and mouth turned to red too, and it was getting worse day by day !fter that, vesicles followed with bullas occurred on several parts of body, very painful when he wanted to swallow food and also when he wanted to pee 2arly diagnosis and withdrawal of suspected drug(s) are very important in management of this type of disease 3atients are need to be cared for in an intermediate or intensive care unit 4anage replacement of "5 fluids and electrolytes as for patient with a third-degree thermal burn
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2arly systemic glucocorticoids in 6iagnose and treat complicating

the disease are reported helpful in reducing morbidity or mortality but this has not been proven 6ebride only frankly necrotic skin

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infections, including sepsis (fever, hypotension, and change in mental status) *reat eye lesions early with erythromycin ointment
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*he initial management in this case is transfusion of 7a8l ),,- 9) drip:minute and in/ection of in/ection of methyl predisolon ($1mg-$1mg-)) to reduce morbidity or mortality 6rip ciprofloxacin $)) mg:#$ hours also given as antibiotic ;n the erosion part treated with 7a8l ),, - wet dressing, Cendo CytrolTM (for eyes problem) and thyamphenicol $- < 6esoxymethason oint to whole the lesions twice a day *he prognosis of vital sign in people with Steven Johnson Syndrome is dubia ad bonam (good) if dealt with the correct therapy *he prognosis of the organs functions of people with Steven Johnson Syndrome by using of the steroids in long term is usually bad because of the effects of steroid prolonged against the body the patient, which leads to another various medical problem "n this case, the progression of this patient is good 7ow he control his medication in policlinic *he last treatment that he take only methyl predisolon % mg:day that already stopped on $$th !pril $)#$ (three days before this presentation) and topical medication i e thyamphenicol $- < 6esoxymethason oint