Concomitance or consequence? Stevens‑Johnson syndrome in COVID‑19: A case report

Abstract

The novel coronavirus infection has been, and still is, a pressing medical problem with a catastrophic effect, not only from a medical point of view, but also from an economic and social one. The cutaneous manifestations of the disease have a diverse morphology and can signal the presence of the infection. The present article reports the case of a 77-year-old male patient admitted at The Sf. Parascheva Clinical Hospital of Infectious Diseases in Iasi (Romania) after testing positive for SARS CoV-2 infection. Initially, the patient presented a pruriginous generalized maculopapular-erythematous eruption with a tendency towards confluence, peri-oro-nasal meliceric crusts and desquamation of the skin on the third anterosuperior and posterior thorax, scalp and forehead, which was accompanied by low back pain, headache and orbital pain. The suspicion of Stevens-Johnson syndrome (SJS) was raised, and treatment was given according to the recommendation of the hospital dermatologist. This association raises multiple questions regarding whether SJS is a cutaneous manifestation of COVID-19 or if there was a concomitance between the viral infection and the immune reaction. The combination of SJS and COVID-19 can have a fatal outcome if not recognized and promptly treated. To our knowledge, this is the first case of SJS in a patient diagnosed with SARS CoV-2 infection in Romania.

Síndrome de Stevens Johnson secundario a infección por covid-19, primer reporte en Latinoamérica de 1 evento adverso extra pulmonar

“…Aunque la infección por COVID-19 es más conocida por su compromiso pulmonar severo, en muchas ocasiones fatal, es una patología que puede afectar múltiples órganos y sistemas, incluyendo la piel y las mucosas, en la literatura se han descrito manifestaciones cutáneas de morfología variable siendo el síndrome de Steven Johson (SSJ)/necrólisis epidérmica tóxica la presentación más grave. (Ochani, R Et al 2021) (Cebeci F. and Çaşkurlu, H. 2020) (Manciuc, C. Et al 2022).…”

Investigation of Four Cases of Stevens–Johnson Syndrome among Participants in a Mass Drug Administration Campaign with Sulfadoxine-Pyrimethamine and Primaquine in Haiti, 2020

“… 6 Recently, multiple case reports described SJS in patients with COVID-19 and exposure to medications, including hydroxychloroquine. 11 – 13 The main difference between the 2018 pilot campaign context and that of 2020 was the appearance of the COVID-19 pandemic. The change in context raised the possibility that SARS-CoV-2 infection might have increased the risk for SJS.…”

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

“…(days) 77-y.o. M30 (Manciuc et al) Chest, back, upper and lower limbs, scalp, forehead Methylprednisolone 250 mg/day, 20 mg bilastine BID, IV vitamin C 500 mg BID, gluconic calcium 10 ml/day, vitonal and gentamicin cream BID, cream of 5 g urea/1 g hydrocortisone/100 g petroleum jelly BID, meropenem 4 mg/day, linezolid 2 g/day, enoxaparine sodium 0.6 mg/day, acetaminophen 500 mg, acetylcysteine 600 mg/day Most lesions above the legs healed after 5 days, but the patient suffered respiratory decompensation on day 7 and entered metabolic acidosis. Died after 20 days of hospitalization.…”