Case Reports of Stevens Johnson Syndrome (SJS) Induced by Chemically Unrelated Drugs

Abstract

Stevens-Johnson syndrome (SJS) is considered as serious mucocutaneous autoimmune disease which is potentially fatal. It may be initiated by medical treatment or infection and sometimes both may be triggering factors. Skin reactions involving loss of skin and mucus membrane and in severe cases, systemic symptoms may be appeared in SJS. In most of the cases medication is the causative factor. Toxic Epidermal Necrolysis (TEN) is a severe form of SJS, as it involves more than 30% of the skin surface with extensive damage to the mucous membranes. SJS and TEN are distinguished based on the extent of the detached skin surface area. It starts with flu-like symptoms, rashes with pain; the upper layer of affected skin dies, sheds and begins to heal after several days. In severe cases, it may leads to life threatening condition. Here we are presenting drug induced SJS in three different cases with different drugs. In first case, a 40-years male treated with Phenytoin 400mg for epilepsy, in second case, a 50-years male was given Amoxicillin + clavulanic acid-625 for some skin lesions and in third case, 50-years old female was given Methotrexate 7.5mg for Rheumatoid arthritis. In all the three cases, SJS symptoms were started within a period of 5-10days. All the symptoms and reactions were noticed and assessed for the confirmations of SJS.