Fatal phenytoin-induced Stevens-Johnson syndrome in an elderly person with metastatic lung carcinoma

Abstract

Health-care providers must be cautious about the adverse effects of drugs, especially Stevens-Johnson syndrome, which is a potentially fatal condition. Several drugs are at high risk of inducing Stevens-Johnson syndrome including allopurinol, sulfonamides, cephalosporins, quinolones, phenytoin, carbamazepine, and nonsteroidal anti-inflammatory drugs. Owing to high risk of mortality, management of patients requires rapid diagnosis, identification and discontinuation of the causative drug, and specialized support care.

Phenytoin-induced Stevens–Johnson syndrome with myocarditis: a rare case report

“…SJS is one of the most debilitating adverse drug reactions recognized 6,7. Both SJS and TEN are debatably included in the same spectrum as erythema multiforme.…”

“…SJS is one of the most debilitating adverse drug reactions recognized. 6 , 7 Both SJS and TEN are debatably included in the same spectrum as erythema multiforme. This mucocutaneous condition shows similarities in clinical presentation to SJS/TEN but exhibits some distinct differences.…”

Aceclofenac Induced Stevens Johnson Syndrome: A Rare Case Report

“…· Toxic epidermal necrolysis: Detachment of more than 30% of the BSA Drugs that are implicated to cause SJS includes penicillins and sulfa antibiotics, carbamazepine, valproic acid, lamotrigine, barbiturates, mirtazapine, infliximab, etanercept, adalimumab etc, (7) but Aceclofenac induced SJS is a rare adverse drug reaction which we have highlighted in this case report. An idiosyncratic, delayed, hypersensitivity reaction could be implicated in the pathophysiology of SJS (9). It has been recognized that drug-induced SJS is a severe hypersensitivity reaction which involves major histocompatibility class -I (MHC) restricted drug presentation and cytotoxic T lymphocytes (CTLs) expansion, which further leads to extensive keratinocyte death in skin lesions [ Figure 4] (10).…”