The scariest hypersensitivity: Stevens Johnson Syndrome

Hypersensitivities Are RealTo read the first part of the story, seeCan your hypersensitivities kill you?

Dr. Sherman examined the Stevens Johnson rash on Allie’s face. It had gotten redder, but he didn’t tell Allie that. She was already frightened enough.

“What medications do you take?” he asked.

“None,” Allie said.

“Not even vitamins?” Dr. Sherman said.

“Vitamins aren’t medicine,” Allie said.

“That’s true,” Dr. Sherman said. He left. Allie could hear him talking to the other doctors. Soon, a young doctor entered Allie’s cubicle. He sat near Allie and smiled at her. He asked her what her favorite hobbies were. They happened to be his favorite hobbies too. They chatted and joked.

Then the doctor (resident) asked her what medications she was taking. “It doesn’t have to be a pill,” he said. “It could be a liquid, like cough syrup.”

Allie said, “I haven’t taken cough syrup in a long time, since the last time I had a cold. I don’t take medicine.”

“Are you sure—”

Allie’s mother arrives

“Yes, she’s sure,” Allie’s mother, who had just entered Allie’s cubicle, said. “She doesn’t take medicine unless it’s directly prescribed by the doctor. Why are you badgering her about medicine?”

“You’re her mother?” the resident said. Allie’s mother nodded.

Dr. Sherman interrupted and asked the resident to leave. Then he turned to Allie’s mother.

“Allie has Stevens Johnson Syndrome,” he said. “A Stevens Johnson rash is caused by drugs. So your daughter must be taking some drug.”

“Are you accusing my daughter of taking street drugs?” Allie’s mother demanded.

“No,” Dr. Sherman and Allie said at the same time.

“Where would  I get street drugs?” Allie said. “I wouldn’t even know what to ask for.”

“Forget the drugs,” Allie’s mother said. “What’s the treatment for a rash like this?”

“Discontinue the drugs,” Dr. Sherman said.

“What else?” Allie’s mother said.

“Nothing else. We discontinue the drugs. We observe her until the rash disappears, then we discharge her. That’s all we can do.”

Will the Rash Kill Allie?

After Allie’s mother left, Dr. Sherman noticed that Allie’s rash had gotten even worse. Pus had started oozing out from under the reddened skin on her face. He didn’t tell Allie, but he didn’t  have to. She already knew what he knew, that the pus eventually pushes the skin off the Hypersensitive’s face. It leaves a scar just as if he or she had been burned, a scar that never heals.

Since Allie’s condition was getting serious, Dr. Sherman had a dermatologist come in. He used a strange-looking ruler called a caliper to measure Allie’s rash.

“Why is he measuring my rash?” Allie asked Dr. Sherman.

“To determine if it has spread enough to qualify as high-level Stevens Johnson Syndrome,” the dermatologist said. “Please hold your head still.”

Afterward, to keep from crying, Allie tried to turn her attention to a silly show on the TV.

“I could be dying,” she thought, “and I feel like a lab specimen too.”

Eventually, she fell asleep. In the morning, she awoke. Right then, Dr. Sherman and the dermatologist came in.

“We need to make arrangements to move Abby to a burn unit,” the dermatologist was saying. Then he saw Abby, and he stopped cold. Dr. Sherman broke into a smile.

The rash had disappeared.

“It looks as if the reaction is over,” he said. “We’ll keep you here a little longer, just in case, but I think your hypersensitive immune system is finished attacking you now.”

“But what caused the rash in the first place?” Allie asked.

“We don’t know,” Dr. Sherman said. “We just don’t know very much about hypersensitivities.”

“If I don’t know what caused it, how do I  keep it from coming back?” she said. No one could answer her.

There are only two things Allie can do: if she starts getting symptoms in the future, watch them carefully. If they get worse, get to a doctor–fast.

Dr. Jean M. Bradt
Ph. D., Psychology, Loyola University of Chicago, 1988

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