Stevens-Johnson syndrome. L51.1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2019 edition of ICD-10-CM L51.1 became effective on October 1, 2018.
Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are now believed to be variants of the same condition, distinct from erythema multiforme. SJS/TEN is a rare, acute, serious, and potentially fatal skin reaction in which there are sheet-like skin and mucosal loss.
Stevens-Johnson syndrome is usually caused by an unpredictable adverse reaction to certain medications. It can also sometimes be caused by an infection. The syndrome often begins with flu-like symptoms, followed by a red or purple rash that spreads and forms blisters. The affected skin eventually dies and peels off.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are a spectrum of the same disease. They are the more severe drug eruptions, with a mortality around 30% for TEN. The confusion between erythema multiforme major and SJS means that erythema multiforme major is the main differential diagnosis.
Causes of Stevens-Johnson syndrome include: Allergic reaction to a medication (most cases of SJS and almost all cases of TEN). Infections, like mycoplasma pneumonia, herpes and hepatitis A.
What is Stevens-Johnson syndrome (SJS) Stevens-Johnson syndrome, named after the two doctors who first described the disease in 1922, is an autoimmune disorder that manifests as a painful rash on the skin, mucous membranes, and genitals. The disease is often caused by an allergic reaction to certain medications.
Serious complications can include pneumonia, overwhelming bacterial infections (sepsis ), shock, multiple organ failure, and death. About 10 percent of people with Stevens-Johnson syndrome die from the disease, while the condition is fatal in up to 50 percent of those with toxic epidermal necrolysis.
Medications that have traditionally been known to lead to SJS, erythema multiforme, and toxic epidermal necrolysis include sulfonamide antibiotics, penicillin antibiotics, cefixime (antibiotic), barbiturates (sedatives), lamotrigine, phenytoin (e.g., Dilantin) (anticonvulsants) and trimethoprim.
The key difference from EM is that SJS/TEN presents with a clinically unwell patient. Appearance of the lesions in SJS/TEN is typically proceeded by a prodromal phase with fever, fatigue, and malaise.
For DRESS syndrome, patients had prodromal symptoms of itching, fever and facial edema. Patients with SJS commonly had prodromal symptoms of fever and malaise. The first skin lesions appeared on the extremities and face in DRESS and on the trunk in SJS (Table 2). The trunk lesions in SJS were tender.
SJS usually starts with a fever and feeling like you have the flu. A few days later, other symptoms appear, including: Painful red or purple skin that looks burned and peels off. Blisters on your skin, mouth, nose, and genitals.