Fuchs Syndrome: Medical Treatment of 1 Case and Literature Review

Gossart, R; Malthiéry, Ève; Aguilar, Fanny; Torres, J.; Fauroux, Marie-Alix

doi:10.1159/000468978

Cited by 7 publications

(3 citation statements)

References 16 publications

(41 reference statements)

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“…Fifteen reports detailing 16 cases were excluded because mucositis was associated with skin lesions covering more than 1% of the skin surface or with target skin lesions. Ultimately, 57 articles were retained for analysis [ 5 , 6 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ]. They had been published between 1945 and 2020 in English ( n = 50), Spanish ( n = 3), Danish ( n = 2), French ( n = 1), and Italian ( n = 1).…”

Section: Resultsmentioning

confidence: 99%

Mucosal Respiratory Syndrome: A Systematic Literature Review

Meoli

Zgraggen

et al. 2021

Dermatology

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Background: Mycoplasma pneumoniae atypical pneumonia is frequently associated with erythema multiforme. Occasionally, a mycoplasma infection does not trigger any cutaneous but exclusively mucosal lesions. The term mucosal respiratory syndrome is employed to denote the latter condition. Available reviews do not address the possible association of mucosal respiratory syndrome with further atypical bacterial pathogens such as Chlamydophila pneumoniae, Chlamydophila psittaci, Coxiella burnetii, Francisella tularensis, or Legionella species. We therefore performed a systematic review of the literature addressing this issue in the National Library of Medicine, Excerpta Medica, and Web of Science databases. Summary: We found 63 patients (≤18 years, n = 36; >18 years, n = 27; 54 males and 9 females) affected by a mucosal respiratory syndrome. Fifty-three cases were temporally associated with a M. pneumoniae and 5 with a C. pneumoniae infection. No cases temporally associated with C. psittaci, C. burnetii, F. tularensis, or Legionella species infection were found. Two cases were temporally associated with Epstein-Barr virus or influenzavirus B, respectively.

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Section: Resultsmentioning

confidence: 99%

Mucosal Respiratory Syndrome: A Systematic Literature Review

Meoli

Zgraggen

et al. 2021

Dermatology

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“…Most of atypical SJS are triggered by infections; Herpes simplex virus (HSV) and Mycoplasma pneumoniae (M.pneumoniae) are common. There are more reports with atypical SJS by M.pneumoniae, especially in children and young people [5][6][7][8][9][10][11][12][13]. But there are few reports of atypical SJS triggered by medications.…”

Section: Discussionmentioning

confidence: 99%

A Japanese Woman with Stevens-Johnson Syndrome without Skin Lesions Induced by an Initial Dosage of Lamotrigine

Sumida¹,

Ishino²,

Saitou³

et al. 2019

AJCEM

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Atypical Stevens-Johnson syndrome (SJS) which is characterized by little or no skin involment, is reported to be triggered by less medications than infection. There are few reports with atypical SJS induced by medications. This is a case report of atypical SJS induced by Lamotrigine (LTG). A 31-year-old Japanese woman, who was bipolar disorder and prescribed an initial dosage of LTG 25mg/day ten days ago, presented with high fever and throat pain for two days. At first she was suspected of pharyngitis and administered antibiotics. She was hospitalized on the first visit day, but she was getting worse and fell into shock over several days. Furthermore she presented with erosions and bleeding of her lips and oral mucosa on day6, and so she was diagnosed with SJS, but her skin lesions were mild even at the extreme of the clinical course. She gradually developed acute pulmonary failure, liver dysfunction, coma and Disseminated Intravascular Coagulation (DIC). But she was treated with intensive care consisting of steroid pulse followed by high dose corticosteroids, and so she gradually recovered from SJS and corticosteroids could be tapered. At last she was discharged on day50 and had no sequelae with SJS. It was extremely difficult to diagnose this case as atypical SJS because of the unremarkable skin lesions and similarity to pharyngitis. It was also characteristic that she was already in severe status when it satisfied the diagnostic criteria for SJS. But physicians should not miss from the perspective of the fatality and social problem. It should be noted that atypical SJS shows mild or little cutaneous lesions.

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“…In severe cases, the condition can lead to acute complications and to long-term sequelae with cutaneous and ocular involvement. 7 Although pharmaceutical drugs are the main trigger of SJS and EEM in both adults and children, EEM is also often triggered by infections, similar to FS. Mycoplasma pneumoniae (MP) infection has been described as typical cause of FS, 4 but also other infectious causes such as HSV infection have been associated with severe FS.…”

Section: E1090 |mentioning

confidence: 99%

SARS‐CoV‐2 infection associated with severe oral, conjunctival and genital lesions (Fuchs syndrome)

Ganjuur

D’Urso

Girbig

et al. 2023

Acad Dermatol Venereol

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Dear Editor, With the onset of the COVID-19 pandemic and the emergence of COVID-19 vaccinations, numerous cases of skin reactions related to SARS-CoV-2 infection and to vaccination have been reported, including urticaria, chilblain lesions and morbilliform rashes. 1,2 Furthermore, the induction or worsening of inflammatory skin diseases was observed. 3 However, reports on severe skin reactions like erythema exsudativum multiforme (EEM), Stevens-Johnson syndrome (SJS) and Fuchs syndrome (FS) related to SARS-CoV-2 infection are scarce. We here present a case of FS after SARS-CoV-2 infection.A 34-year-old Caucasian woman presented to our dermatological outpatient clinic with severe acute fatigue, fever, malaise, swelling of cervical lymph nodes and sudden development of infiltrating lesions on mucous membranes. Four days before, blisters and ulcers developed in the oral mucosa, the lips and the genital mucosae with concomitant conjunctivitis. No other skin lesions were observed. Initial treatment with acyclovir 5 × 800 mg by her general practitioner showed no improvement. The patient reported no other medical history, but an asymptomatic SARS-CoV-2 infection verified by an antigen test 2 weeks before first symptoms. Clinical examination revealed haemorrhagic erosions with crusting on the lips and eroded lingual lesions (Figure 1). Marked conjunctival infiltration was observed in both eyes (Figure 2). This symptom complex was clinically diagnosed as FS. To rule out differential diagnoses, extensive blood analyses were performed, and mucosal swabs taken, excluding herpes simplex virus (HSV) infection by polymerase chain reactions. Elevated C-reactive protein to 84 mg/L (reference: <5 mg/L) and thrombocytosis were observed (493 bn/L [150-370 bn/L]); liver and renal function test, white and red blood count, electrolytes and anti-streptolysin titre revealed normal results.The patient had been vaccinated against COVID three times, the last being applied 18 weeks before the onset of acute mucosal lesions. We thus concluded that this episode of FS was most likely triggered by SARS-CoV-2 infection. Due to malaise, fever, fatigue and severely worsening general condition, the patient was admitted to a dermatology hospital. Treatment included systemic prednisolone (100 mg/daily for 3 days), topical antiseptics and anaesthetic mouthwash. After ophthalmological review, prednisolone eye drops were applied for conjunctival involvement. The patient fully recovered within a week without any clinical sequelae.Clinical diagnosis of acute severe SJS-like mucosal lesions in the absence of extramucosal lesions has been described as FS. Currently, there is no published consensus on the specific criteria of FS. It is considered a rare clinical variant of erythema multiforme majus (EEM). 4 Although

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Fuchs Syndrome: Medical Treatment of 1 Case and Literature Review

Cited by 7 publications

References 16 publications

Mucosal Respiratory Syndrome: A Systematic Literature Review

Mucosal Respiratory Syndrome: A Systematic Literature Review

A Japanese Woman with Stevens-Johnson Syndrome without Skin Lesions Induced by an Initial Dosage of Lamotrigine

SARS‐CoV‐2 infection associated with severe oral, conjunctival and genital lesions (Fuchs syndrome)

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