QUESTION: About two years ago, my husband was hospitalized with a severe reaction to a sulfa drug. Not only did he have a body rash, but his lips were swollen and distorted and his feet and hands swollen. The doctors called it Stevens-Johnson (S-J) syndrome. My husband is fine now, but I need information on it, which I can't find in the medical books. What about recurrence? - Mrs. W.F.
ANSWER: Sulfa is not the only drug that can cause this rare reaction. It can happen with penicillin, barbiturates and phenytoin, among others. It also can happen after some infections, like herpes, strep and mycoplasma. Although rare, this reaction can be serious, and your husband seems to have had one of the more severe kinds.Another name for S-J is erythema multiforme major. If you look under that name, you might find some information.
The typical rash of S-J is a central dark purple area surrounded by a pale zone with an outer red rim. The central area may blister. Mouth linings also may be affected, and joint swellings may ensue. The whole thing is typical of any severe allergic reaction. Most S-J patients resume perfect health. However, your husband should try to nail down the cause. It can happen again.
QUESTION: I have a question, more out of curiosity than anything else. I had a physical recently, and it was done by a new doctor. He took my blood pressure in my legs. I asked him what the reading was, and he told me it was 15 points higher than the pressure in my arms. How come? Is that normal? - He said nothing more. - Mrs. C.P.
ANSWER: It is normal for leg pressure to be 10 to 40 points higher than arm pressure. Gravity has something to do with it. If leg pressure isn't appropriately higher than arm pressure, something is wrong, like a block in the leg arteries. You have a thorough doctor. For more on blood pressure, see the hypertension report I'm mailing. Others may order by writing: Dr. Donohue/No. 4, P.O. Box 5539, Riverton, NJ 08077, enclosing a long, stamped (52 cents), self-addressed envelope and $2.
QUESTION: Can you please tell me how TB of the bone is diagnosed and what the symptoms are? Anxiously awaiting your answer. - Anon.
ANSWER: Bone tuberculosis is hard to diagnose. So are most bone infections. Symptoms, like gnawing pain that won't go away, often are mistaken for arthritis.
Bone TB commonly occurs in the spine, so you get back pain rather like muscular pain. X-rays, bone scans, and magnetic resonance imaging permit better diagnosis than in earlier days. You can tell if infection is present, although not the type. A biopsy tells that.
If do you have bone TB? write back. I am interested in this subject and would like to know more about your case.
QUESTION: I know a woman who pulls out her hair. What is the name of this problem and the sort of doctor to see? Incidentally, I read about carpal tunnel syndrome from your column a few years back, had the wrist surgery, which relieved the pain. Thanks. - J.H.
ANSWER: This is called trichotillomania, an all but irresistible hair pulling urge. Perhaps 4 percent of the population has some degree of this. It may be a subconscious tension reliever.
Among control drugs is clomipramine (Anafranil). But you also must undergo behavioral modification and relaxation therapy for thorough treatment. I am glad to hear that my discussion of the finger pain problem (carpal tunnel syndrome) helped steer you toward effective treatment. You made my day.
Dr. Donohue welcomes reader mail but regrets that, due to the tremendous volume received daily, he is unable to answer individual letters. Readers' questions are incorporated in his column whenever possible.