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Re: Stevens-Johnson

Posted by Jost on June 19, 2006, at 23:34:19

In reply to Re: Stevens-Johnson, posted by Sobriquet Style on June 19, 2006, at 15:36:46

To clarify the likelihood that anyone is suffering SJS, I'd like to add a few facts I picked up just now.

First, SJS is extremely rare. There are minor and severe variants, of which SJS and something called TEN are the more severe. They can be quite severe.

However, ulcers, or pain in one's mouth is a rather common, and often not very serious (medically, at least) condition, even if it is extremely uncomfortable or distressing.

SJS and TEN, on the other hand, have an incidence rate of about 4.6 per 1,000,000 person years. That seems to mean (I couldn't find a really good definition, so I'm somewhat guessing) that there are 4.6 cases per 1 million people per year (between the ages of 20 and 60--somewhat more before twenty and after 60).

Moreover, most cases, while drug-related, are related to

1. antibiotics and sulfonamides
2. certain seizure medications
3. diureticss

Moreover, these serious forms have manifestations outside the mouth.

So I'd say that while I can't absolutely 100% rule out lamictal as causing whatever this problem is, when doing a differential diagnosis, one would start with more common things and get to SJS way way way down the line. And that's even if you're taking one of those medications- Since lamictal wasn't one of the anit-seizure medications mentioned, you odds decrease significantly.

There's a thing called "heuristic bias"--which means if you hear about a horrible disease, you may suddenly find that something makes you think you could have it. However, you knowing about it, makes it no more likely that you have it. It just brings it into your radar.

Which in the case of rare, horrible diseases is not justified. At all. So don't google this disease. We've probably got things to worry about, and this isn't one of them.

Jost


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