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When was the SJS diagnosis?
When was the SJS diagnosis?
*
Within The Last Two Years
2-4 Years Ago
More Than 4 Years Ago
Were you hospitalized as a result of SJS?
Were you hospitalized as a result of SJS?
*
Yes
No
How long were you hospitalized?
How long were you hospitalized?
*
less than 1 week
1-4 weeks
more than one month
What drug caused SJS?
What drug caused SJS?
*
Not sure
Advil
Anticonvulsants
Antiepileptic drugs
Antimalarial drugs
Arava
Azithromycin
Bactrim
Carbamazepine
Children’s Advil
Children’s Motrin
Children’s Tylenol
Cleocin
Clindamycin
Diclofenac
Dietary supplements
Diflucan
Dilantin
Flagyl
Libtayo
Leflunomide
Phenytoin
Sulfonamides
Tamiflu
Tegretol
Topamax
Various NSAIDs
Xeljanz
Zithromax
Zosyn
Other
Thank you for using our Virtual Case Tool.
Please provide your contact information so a member of our team can reach out to you.
First Name
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Last Name
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State
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Phone
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e.g. (555) 555-5555
Email
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