Diagnosis Of Stevens-Johnson Syndrome

Doctors often can identify Stevens-Johnson syndrome based on your medical history, a physical exam and the disorder's distinctive signs and symptoms. To confirm the diagnosis, your doctor may take a tissue sample of your skin (biopsy) for examination under a microscope.

No specific laboratory studies (other than biopsy) exist that can definitively establish the diagnosis of Stevens-Johnson syndrome.

• A complete blood count (CBC) may reveal a normal white blood cell (WBC) count or a nonspecific leukocytosis. A severely elevated WBC count indicates the possibility of a superimposed bacterial infection.
• Skin and blood cultures have been advocated because the incidence of serious bacterial bloodstream infections and sepsis contribute to morbidity and mortality.
• Determine renal function and evaluate urine for blood.
• Electrolytes and other chemistries may be needed to help manage related problems.
• Cultures of blood, urine, and wounds are indicated when an infection is clinically suspected.
• Bronchoscopy, esophagogastroduodenoscopy (EGD), and colonoscopy may be indicated.

Chest radiography may indicate the existence of a pneumonitis when clinically suspected. Otherwise, routine plain films are not indicated.

Skin biopsy is the definitive diagnostic study but is not an emergency department (ED) procedure.

• Skin biopsy specimens demonstrate that the bullae are subepidermal.
• Epidermal cell necrosis may be noted.
• Perivascular areas are infiltrated with lymphocytes.

Although the clinical presentation and patient history usually make the diagnosis of TEN evident, other conditions should be considered in the differential diagnosis - mainly in the early stages of disease when the complete picture may not be obvious. The differential diagnoses for TEN include SSSS, acute graft-versus-host disease, linear IgA dermatosis, paraneoplastic pemphigus, pemphigoid and pemphigus, and AGEP.

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Diagnose Acne

There is no medical test used to diagnose acne. A diagnosis is made only with a visual examination. Most people can recognize and diagnose acne themselves; however, there is a tendency to overreact. One zit or one pimple does not constitute a full-blown case of the disease.

However, if you are unsure if what you are experiencing is acne, or if your acne seems severe, see your dermatologist.

Some skin conditions can look remarkably similar to acne, although their causes and treatments are different. Do you have acne or an acne look-alike condition? If you are unsure, it is always wise to consult with a doctor. Common skin conditions that can be mistaken for acne include:

• Rosacea - Causes red, flushed skin with papules and pustules, especially in the nose and cheek area.
• Folliculitis - Bumps or pustules caused by inflammation of the hair follicle.
• Keratosis pilaris - Small, rough, "goose-flesh" like bumps most often found on the upper arms, thighs and buttocks, and sometimes the face.
• Miliaria rubra - Small red bumps on the surface of the skin caused by excessive heat exposure. Also known as heat rash.

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