scholarly journals Blepharoconjunctivitis as Manifestation of Stevens-Johnson syndrome

2021 ◽  
Vol 5 (2) ◽  
pp. 26-32
Author(s):  
Putu Ayu Adindhya Saraswati Surya ◽  
Ni Nyoman Sunariasih
Keyword(s):  
Sharp Decrease ◽  
Stevens Johnson Syndrome ◽  
Eye Drops ◽  
Corneal Ulcers ◽  
Corneal Erosion ◽  
Ocular Manifestations ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Life Threatening ◽  
History Of

Background: Stevens Johnson syndrome (SJS) is a collection of acute and life threatening skin symptoms caused by an allergic drug reaction. SJS also attacks the other mucous membranes, one of which is the eye. SJS is a rare case. The initial complaint of SJS is the eruption on the skin in the form of redness followed by blisters and attacking other mucous membranes. The ocular manifestations of SJS are conjunctivitis, corneal erosion, corneal ulcers, and blepharitis. Methods: Treatment of SJS’s ocular manifestation is administration of drugs and surgical intervention. Administration of drugs that often done in the acute phase is antibiotic eye drops with steroids to prevent complications. Complications that can occur include symblepharon, districhiasis, and keratitis. This complication can cause a sharp decrease in vision. Results: This case report discusses a 68 year old male patient with blisters all over his body accompanied by swelling in both eyes, redness in both eyes, and difficult to open eyes. Patients with history of taking the new drug a month ago. No history of drug allergy. The patient suffered from hypertension, non-hemorrhagic stroke, and epilepsy with irregular treatment. Patient was performed a fluorescein test. In this case, the patient is given antibiotic ointment and artificial tears with steroids. In this case there were no complications. Conclusion: The ocular manifestations of SJS if handled quickly and properly can prevent long-term complications.

scholarly journals Meropenem-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in a patient with known type IV penicillin hypersensitivity

2019 ◽  
Vol 12 (8) ◽  
pp. e230144 ◽  
Author(s):  
Muhammad Sameed ◽  
Christine Nwaiser ◽  
Prashant Bhandari ◽  
Sarah A Schmalzle
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Cross Reactivity ◽  
Delayed Hypersensitivity ◽  
Stevens Johnson Syndrome ◽  
Hypersensitivity Reactions ◽  
Beta Lactam ◽  
Type Iv ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
History Of

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered variants of a disease continuum that results in a life-threatening exfoliative mucocutaneous disease. These are categorised as type IV cell-mediated delayed hypersensitivity reactions, and antibiotics are often implicated as a cause. Penicillins and other beta-lactam antibiotics are known to cause both immediate and delayed hypersensitivity reactions. While immediate IgE-mediated cross-reactivity between penicillins and carbapenems is well studied, less information on the risk of type IV delayed cell-mediated cross-reactivity between the two is available. We present a case of meropenem-induced SJS in a patient with documented history of SJS from amoxicillin. There are few cases of cross-reactivity with carbapenems reported in the literature, but based on the potential for life-threatening reaction, it is likely prudent to avoid the use of any beta-lactams in a patient with a history of SJS, TEN or any other severe cutaneous adverse reactions to another beta-lactam antibiotic.

scholarly journals Rifampicin- and allopurinol-induced Stevens-Johnson syndrome: A case series

2021 ◽  
Vol 65 ◽  
pp. 51-54
Author(s):  
Bhavana Srivastava ◽  
Reena Bhardwaj ◽  
Renu Khanchandani ◽  
Zafar Masood Ansari ◽  
Gunjita Belwal
Keyword(s):  
Adverse Effects ◽  
Pulmonary Tuberculosis ◽  
Causality Assessment ◽  
Case Series ◽  
Young Male ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Life Threatening ◽  
Severe Skin Reaction

Stevens-Johnson syndrome (SJS) is a rare, serious disorder and may be life threatening affecting mainly mucocutaneous tissues. It is a type of generalised, multisystemic hypersensitivity reaction directly linked to the drug intake. It is one of the few serious adverse effects of drugs involving skin and mucous membranes which are characterised by rash, bullae and blisters spread on skin, mucous membranes, swelling with erosive lesions on lips and face and hyperpigmentation. Normally, SJS is a self-resolving condition but it has potential to be converted into life-threatening disease. Here, we describe and present a case series of SJS inflicted by rifampicin and allopurinol. First one is a 28-year-old-female and second case is a 50-year-old male, both received rifampicin for pulmonary tuberculosis. Third patient is a 22-year-old young male taken allopurinol for hyperuricemia. All these patients noticed a severe skin reaction which is a part of erythema multiforme spectrum. Causality assessment was done in these patients with the help of Naranjo’s algorithm and diagnosed as cases of SJS.

scholarly journals Cutaneous Adverse Drug reactions: A Four-Year Study from Western Nepal

2018 ◽  
Vol 10 (2) ◽  
pp. 21-26 ◽  
Author(s):  
S Neupane ◽  
B Basnet
Keyword(s):  
Adverse Drug Reactions ◽  
College Teaching ◽  
Clinical History ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Medical College ◽  
Johnson Syndrome ◽  
Detailed Clinical History ◽  
Life Threatening ◽  
History Of

Background: Cutaneous adverse drug reactions (CADRs) range from minor reactions to several life threatening complications. Objectives: To study the clinical spectrum of cutaneous adverse drug reactions, determine the causative drugs responsible for the reactions and to assess the preventability.Methods: The study was carried out in the Department of Dermatology of Gandaki Medical College Teaching Hospital from June 2011 to June 2015. All the patients attending the Dermatology Outpatient Department and the patients admitted in the wards with suspected cutaneous adverse drug reactions to systemic drugs were included in the study. A detailed clinical history, including the history of drug intake was noted. Each case was assessed for its causality by using the WHO definitions. Data analysis was done using SPSS software.Results: There were 102 patients in total. The mean age of the patient was 32 ±15.7 years. Maximum patients belonged to the 21 to 30 years age group. There were 59 female patients and 43 male patients. Severe type of cutaneous adverse drug reactions was noted in 7.8% of patients. Antibiotics were responsible for most of the cutaneous adverse drug reactions. Cefixime was the most commonly incriminated drug. Exanthematous drug reaction was the most common type seen in 45%. Stevens-Johnson syndrome was the commonest type noted among the serious adverse drug reactions. Drug preventability was noted in 6% of patients.Conclusions: The commonest type of CADR noted was exanthematous type. Antibiotics were the commonest drug group involved in CADR. Six percent of CADR were preventable. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 21-26

scholarly journals Stevens-Johnson Syndrome in a Child on Phenytoin, Exacerbated with Cefixime

2019 ◽  
Vol 39 (3) ◽  
pp. 193-196 ◽  
Author(s):  
Yam Bahadur Roka ◽  
Sabrina Shrestha ◽  
Narayani Roka ◽  
Mohan Karki
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Whole Body ◽  
Stevens Johnson Syndrome ◽  
Intravenous Fluids ◽  
Oral Ulceration ◽  
Topical Antibiotics ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
History Of ◽  
Steven Johnson Syndrome

Steven Johnson syndrome and toxic epidermal necrolysis are rare but potentially life threatening muco-cutaneous disorders. Their incidence ranges from 1.2 to six per million patient-years for Steven Johnson syndrome and 0.4 to 1.2 per million patient-years for toxic epidermal necrolysis. Drugs are the primary cause for these syndromes in majority cases. They might also be due to infections with Mycoplasma Pneumoniae or Herpes Simplex. The mortality ranges from five to 40% in these cases. We report a 10-year old girl who presented with history of multiple skin eruptions involving whole body and oral ulceration for five days. She was a known case of seizure disorder on phenytoin and had been prescribed Cefexime for fever. She was managed with intravenous fluids, corticosteroids, opiates, antacids and topical antibiotics. We want to highlight the possibility of Steven Johnson syndrome following the combination of these two drugs.

scholarly journals Nevirapine induced Stevens Johnson syndrome

2020 ◽  
Vol 1 (2) ◽  
pp. 35-38
Author(s):  
Himani Prajapati ◽  
Neetu Bala ◽  
Dinesh Kansal
Keyword(s):  
Adverse Effect ◽  
Adverse Event ◽  
Causality Assessment ◽  
Burning Sensation ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Case Presentation ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
History Of

Introduction: Severe and life-threatening SJS is more common with nevirapine than with other NNRTIs Case presentation: A 56-year-old male patient presented with a complaint of lesions all over the body with a burning sensation for 4 days. He was on an ART regimen, containing zidovudine, lamivudine, and efavirenz combination for 4 years. But patient accidentally started nevirapine and after 10 days he developed maculopapular lesions which were diagnosed as SJS syndrome. There was a history of rash with nevirapine when ART was started initially in 2012. This incident of an adverse event could be assigned a term "probable" according to the WHO-UMC scale for causality assessment as the re-challenge was found positive. Conclusion: Physicians and patients must be aware of this adverse effect on early diagnosis and treatment.

scholarly journals Severe dry eye associated with Steven Johnson Syndrome: A case report

2021 ◽  
Vol 7 (2) ◽  
pp. 225-228
Author(s):  
Namrata Shree ◽  
Baby Deka ◽  
Rajneel Bhattacharjee
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Acute Stage ◽  
Stevens Johnson Syndrome ◽  
Corneal Surface ◽  
Eye Pain ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Life Threatening ◽  
Steven Johnson Syndrome

: Stevens-Johnson-Syndrome (SJS), and its severe variant, toxic epidermal necrolysis (TEN), are life-threatening diseases of skin and mucous membranes. Cases with pseudo-membrane formation and epithelial defects, have higher risk of ocular sequelae. Severe dry eye in SJS includes three mechanisms: (1) aqueous tear deficiency, (2) decreased wettability of corneal surface, and (3) increased evaporation.: A 47-year-old male patient presented in OPD with chief complaint of severe discomfort and grittiness in both eyes since last 21 years. Proper history taking and examination was done. Patient was given conservative treatment and was explained about recent advancements of treatment that can help in improving his condition.: In SJS patients, dryness causes eye pain, and unstable tear film causes diminution of vision. After acute stage reactions, visual impairment and severe dry eye are observed as ocular sequelae.

Stevens-Johnson syndrome

2016 ◽  
Vol 19 (4) ◽  
pp. 216-220
Author(s):  
O. Yu Olisova ◽  
O. V Grabovskaya ◽  
N. P Teplyuk ◽  
A. A Lepekhova ◽  
D. V Ignatiev ◽  
...  
Keyword(s):  
Clinical Case ◽  
Clinical Presentation ◽  
Stevens Johnson Syndrome ◽  
High Dose ◽  
Treatment And Prevention ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Systemic Glucocorticoids ◽  
Life Threatening ◽  
Methods Of Treatment

The literature review of the epidemiology, etiology and pathogenesis, clinical presentation and diagnosis of the syndrome of Stevens-Johnson severe life-threatening disease characterized by extensive lesions of the skin and mucous membranes, fever and bone and muscle aches, often induced by medication is presented. A review on the methods of treatment and prevention of this disease is presented. The clinical case of patient with the syndrome of Stevens-Johnson is described. The successful treatment of Syndrome Stevens-Johnson with high-dose systemic glucocorticoids was performed.

New Grading System for the Evaluation of Chronic Ocular Manifestations in Patients with Stevens–Johnson Syndrome

Ophthalmology ◽  
2007 ◽  
Vol 114 (7) ◽  
pp. 1294-1302 ◽  
Author(s):  
Chie Sotozono ◽  
Leonard P.K. Ang ◽  
Noriko Koizumi ◽  
Hisayo Higashihara ◽  
Mayumi Ueta ◽  
...  
Keyword(s):  
Stevens Johnson Syndrome ◽  
Grading System ◽  
Ocular Manifestations ◽  
Johnson Syndrome

Warning against long-acting sulphonamides

1966 ◽  
Vol 4 (4) ◽  
pp. 13-13
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Erythema Multiforme ◽  
The United States ◽  
Stevens Johnson Syndrome ◽  
Warning Letter ◽  
Johnson Syndrome ◽  
The Us ◽  
Mucous Membranes ◽  
Long Acting

Last month the US Food and Drug Administration required American manufacturers of long-acting sulphonamides (sulphamethoxypyridazine, Lederkyn - Lederle and Midicel - PD; sulphadimethoxine - Madribon - Roche) to warn prescribers that in rare cases the Stevens-Johnson syndrome may develop as a severe and sometimes fatal side effect. This syndrome is a type of erythema multiforme in which large blisters appear on the skin and especially on the mucous membranes. The manufacturers were also to advise doctors ‘to consider prescribing short-acting sulphonamides first because they are effective for most of the same conditions’. The three drug firms concerned accordingly sent a joint warning letter to all doctors, pointing out that the Stevens-Johnson syndrome is a serious complication with a mortality rate of about 25%. So far 116 cases of this syndrome have been reported in association with the use of long-acting sulphonamides, most of them in the United States. Almost two thirds of the patients were children.

scholarly journals Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis; Extensive Review of Reports of Drug-Induced Etiologies, and Possible Therapeutic Modalities

2018 ◽  
Vol 6 (4) ◽  
pp. 730-738 ◽  
Author(s):  
Adegbenro Omotuyi John Fakoya ◽  
Princess Omenyi ◽  
Precious Anthony ◽  
Favour Anthony ◽  
Precious Etti ◽  
...  
Keyword(s):  
Adverse Drug Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Stevens Johnson Syndrome ◽  
Hypersensitivity Reactions ◽  
Extensive Review ◽  
Drug Induced ◽  
Therapeutic Modalities ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Degrees Of Severity

Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis are adverse hypersensitivity reactions that affect the skin and mucous membranes. They are characterised by erythematous macules and hemorrhagic erosions of the mucous membranes. Epidermal detachments of varying degrees of severity also occur in these conditions. Various aetiologies are associated with these conditions, with adverse drug reaction being the most common. Though the worldwide incidence of these conditions is recorded as low, diverse types of medication are being observed to lead to these conditions. This review compiles information on the details of Stevens-Johnson syndrome and Toxic Epidermal Necrolysis, the pathophysiology, therapeutic management, and largely considers the drug-induced etiologies associated with these conditions.

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