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Revista argentina de dermatología
On-line version ISSN 1851-300X
Abstract
MAYORIANO, YE Lázaro; RODRIGUEZ, LJ Vargas and VARGAS, GC Moreno. Steven Johnson syndrome: Clinical case. Rev. argent. dermatol. [online]. 2021, vol.102, n.1, pp.31-40. ISSN 1851-300X.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) are considered as a spectrum of rare but potentially fatal skin diseases. The case of a 55-year-old woman with a history of epilepsy secondary to cavernous angiomas under management with phenytoin is presented. She attended for a clinical picture of two days of evolution consisting of facial edema associated with pruritic skin eruption in the thoracocervical region, dysphagia and unquantified feverish peaks. On physical examination with hyperemia and conjunctival injection, upper and lower lip edema with whitish and painful thrush-like lesions. In the skin, a maculopapular, confluent and erythematous rash that disappears when digitopressured, predominantly in the trunk and upper extremities. Given these results, it was suggested that the patient be studying with Steven Johnson syndrome. This is a pathology of low prevalence, generally secondary to an idiosyncratic reaction that in most cases occurs through medications such as antibiotics, anticonvulsants, non-steroidal anti-inflammatory drugs, among others. Management is based on early diagnosis, removal of causal substances, strict monitoring of body fluids, temperature, isolation and proper skin care. Within pharmacological measures, intravenous immunoglobulin can be used.
Keywords : Stevens Johnson syndrome; Anticonvulsants; Keratinocytes; Epidermis.