SJS vs. SSS
So here’s the skinny.
The pediatric department saw the results of the initial biopsy, and based on the “level of engagement” of the skin at that site, determined that it was most consistent with SSS. It wasn’t based on the presence of Staph or the protein responsible for SSS or anything definitive like that.
The head dermatologist and his team, who are more knowledgable in these particular skin conditions, believes that those results are simply due to the site on Harlan’s body that was sampled for the biopsy; he believes that if they had biopsied other sites, they would have seen different levels of engagement more consistent with SJS. He still favors the SJS diagnosis for a few reasons:
- Harlan’s mucous membranes were heavily affected (lips, eyes, etc.), and SSS does not affect mucous membranes like that (only SJS).
- Harlan started getting better very quickly following the IVIG treatment, which would only happen for SJS (and not SSS).
- The percentage of Harlan’s body surface that was affected is more consistent with SJS than SSS.
The dermatology department was more heavily involved in overseeing Harlan’s case since both of those conditions fall under their purview, so Heather and I feel inclined to trust their judgement over that of the general pediatrics department.
My next post will probably be after Harlan comes home (most likely tomorrow), and then once more after our follow up appointment with the dermatologists next Wednesday with more information about his condition for anyone interested in that.