Phenytoin-induced Stevens-Johnson Syndrome: A case report
DOI:
https://doi.org/10.66344/jpad.33.2.2023.2085Abstract
Stevens-Johnson syndrome (SJS) is a rare but serious and often life-threatening acute mucocutaneous reaction. Majority of cases are drug-induced resulting extensive exfoliation which may cause severe dehydration and mortality. An-18 year old female reported with chief complaint of generalized edematous erythematous rash with multiple hyperpigmentation on the skin of the face, neck, chest, back, bilateral extremities, and genital area. These acute skin reactions were evoked after consumption of phenytoin and she was treated with corticosteroids, antibiotics, and other symptomatic treatment. Clinicians must be adept at identifying hypersensitivity reactions especially SJS which is a potentially fatal condition. The most commonly prescribed drug regimens which may induce drug allergy should be used judiciously, and alternative safer regimens may be considered if available.References
Valeyrie L, Claude J. Epidermal necrolysis (Stevens-Johnson syndrome and toxic epidermal necrolysis). In: Wolff K, Goldsmith LA, Katz SI., editors. Fitzpatrick’s dermatology in general medicine. 8th ed. New York: Mc Graw Hill; 2012. p.439-49.
Wong A, Malvestiti AA, Hafner Mde F. Stevensâ€Johnson syndrome and toxic epidermal necrolysis: a review. Rev Assoc Med Bras. 2016;62:468–73.
Djuanda A, Hamzah M. Sindrom stevens-johnson. In: Djuanda A, Hamzah M, Aisah S, editors. Ilmu penyakit kulit dan kelamin. 6th Ed. Jakarta: Balai Penerbit Fakultas Kedokteran Indonesia; 2010. p.163-5
Deore SS, Dandekar RC, Mahajan AM, Shiledar VV. Drug induced - Stevens Johnson Syndrome: a case report. Int J Sci Stud. 2014;2(4):84-7.
Wang F, Ma Z, Wu X, Liu L. Allopurinol-induced toxic epidermal necrolysis featuring almost 60% skin detachment. Medicine (Baltimore). 2019;98(25):e16078.
Hun YF, Wu XT, et al. Phenytoin-induced Stevens–Johnson syndrome with negative HLA-B*1502 allele in mainland China: two cases. Seizure. 2011;20:431-2
Bhanu LP, Kumara SM, Nasiruddin M, Naveen HD, Venkataraman R. Stevens-Johnson syndrome induced by phenytoin: a case report. Int J Basic Clin Pharmacol. 2017;6:208-10
Lobao B, Martins C, Sousa M, Marques S, Pedroso E. Phenytoin-induced Lyell's Syndrome. BMJ Case Report. 2012;70:121-2.
Schmidt D, Kluge W. Fatal toxic epidermal necrolysis following re-exposure to phenytoin: a case report. Epilepsia. 1983;24:440-3.
Horjeti E, Kola E, Guy A, Musa J, Ekladous J. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in twin sisters after ibuprofen administration. New insights in pathogenesis and literature review. J Case Rep Stud. 2019;7(6):603.
Man CB, Kwan P, Baum L, Yu E, Lau KM, Cheng AS, et al. Association between HLA-B*1502 allele and antiepileptic drug-induced cutaneous reactions in Han Chinese. Epilepsia. 2007;48:1015–8.
Locharernkul C, Loplumlert J, Limotai C, Korkij W, Desudchit T, Tongkobpetch S, et al. Carbamazepine and phenytoin induced Stevens–Johnson syndrome is associated with HLA-B*1502 allele in Thai population. Epilepsia. 2008;49:2087–91.
Hung SI, Chung WH, Liu ZS, Chen CH, Hsih MS, Hui RC, et al. Common risk allele in aromatic antiepileptic-drug induced Stevens–Johnson syndrome and toxic epidermal necrolysis in Han Chinese. Pharmacogenomics. 2010;11:349–56.
Downloads
Published
How to Cite
Issue
Section
License
Submission declaration
Authors retain the copyright to their work and grant the 'Journal of Pakistan Association of Dermatologists (JPAD)' the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
By submitting a manuscript, authors confirm that the work has not been published previously (except as an abstract, lecture, or academic thesis), is not under review elsewhere, and has been approved by all authors and relevant authorities. Once accepted, the article will be openly accessible under the CC BY 4.0 license, ensuring wide dissemination and reuse with proper attribution.