Stevens-Johnson Syndrome: a case of a 61-year-old male presenting with multiple macules and patches

Maria Jorquiza  Salvador,

Stevens-Johnson Syndrome: a case of a 61-year-old male presenting with multiple macules and patches

Abstract:

Stevens-Johnson Syndrome (SJS) is a rare serious disorder of the skin and the mucous membrane. A 61-year-old presented with multiple macules and patches on chest, posterior thoracic, abdomen and upper and lower extremities, inguinal and scrotal areas. He had dry hemorrhagic crusting on his upper and lower lip and buccal mucosa, and complained of dysphagia and foreign body sensation on the eye. Based on the list and duration of the multiple medications he was taking, allopurinol was most likely the culprit. He was treated with intravenous, topical and oral hydrocortisone. The use of corticosteroids provided good outcome.

References:

Hung SI,Chung WH, Liou LB,Chu CC,Lim M, Huang HP,et al. HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol. Proc Natl Acad Sci U5A. 2005; 102:4134-4139. Available from: https://pubmed.ncbi.nlm.nih.gov/15743917/
D. Creamer ,S.A. Walsh ,P. Dziewulski, L.S. Exton, H.Y. Lee , et al. U.K. guidelines for the management of Stevens–Johnson syndrome/toxic epidermal necrolysis in adults, British Journal of Dermatology (2016) 174, pp1194–1227. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/bjd.14530
Dane H. Slentz, BS, and Houman D. Hemmati, MD, PhD, Ophthalmic pearls, Management of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis, American Academy of Ophthalmology 2013. Available from: https://www.aao.org/eyenet/article/management-of-stevensjohnson-syndrome-toxic-epider-2
Onishi, Emy and Frasisca Roa. “Stevens-Johnson syndrome and toxic epidermal necrolysis at the Philippine General Hospital: A seven year retrospective study.” Journal of The Philippine Dermatological Society 22.1 (2013): 29-37.
National Organization for Rare Disorders, Available from https://rarediseases.org/rare-diseases/stevens-johnson-syndrome-and-toxic-epidermal-necrolysis/
Gupta LK, Martin AM, Agarwal N, D’Souza P, Das S, Kumar R, et al. Guideline for the management of Stevens-Johnson Syndrome/toxic epidermal Necrolysis: An Indian perspective. Indian J Dermatol Venereol Leprol 2016;82:603-25. Available from: https://pubmed.ncbi.nlm.nih.gov/27716721/
Anekar AA, Cascella M. WHO Analgesic Ladder. In: Stat Pearls. Treasure Island (FL): StatPearls Publishing; May 17, 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554435/
Coutinho AE, Chapman KE. The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights. Mol Cell Endocrinol. 2011;335(1):2-13. doi:10.1016/j mce.2010.04.005. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047790/
Shang-Chen Yang, Sindy Hu, Sheng-Zheng Zhang, Jin-wen Huang, Jing Zhang, Chao Ji, Bo Cheng, “The Epidemiology of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in China”, Journal of Immunology Research, vol. 2018, Article ID 4320195, 10 pages, 2018. https://doi.org/10.1155/2018/4320195. Available from: https://www.hindawi.com/journals/jir/2018/4320195