Toxic Epidermal Necrosis with Complicating Course of Conjunctivitis and Synechiae of Labia to Rectovaginal Fistula: A Rare Case
Keywords:
Toxic Epidermal Necrolysis, Vaginal Synechiae, Rectovaginal Fistula, ConjunctivitisAbstract
Toxic epidermal necrolysis (TEN) is a severe drug-related reaction characterized by mucosal erosion and epidermal detachment occurring on more than 30% of the body surface area. Vaginal complications have been reported in about 50% of patients with TEN. Here, we report a 58-year-old woman who presented with com-plaints of red peeling rashes that initially appeared in the armpits and then spread to all of the body include mucosa eyes, mouth, and vagina. The complaints arose after the patient took meloxicam and allopurinol. TEN complications in the mucosa of the eyes and mouth are frequently encountered, but vaginal synechia comp-licating into a rectovaginal fistula is a very rare case. The author could hardly find any references mentioning rectovaginal fistula as a subsequent complication of TEN. Therefore, further research is needed regarding rectovaginal fistula as a complication of TEN.References
Paulmann M, Mockenhaupt M. Severe skin react-ions: clinical picture, epidemiology, etiology, path-ogenesis, and treatment. Allergo J Int. 2019;28(8):311–26.
Dobry AS, Himed S, Waters M, Kaffenberger BH. Scoring Assessments in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis. Front Med (Lausanne). 2022;9:883121.
doi: 10.3389/fmed.2022.883121.
Frantz R, Huang S, Are A, Motaparthi K. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management. Medicina (Kaunas). 2021;57(9):895. doi: 10.3390/medicina57090895
Grünwald P, Mockenhaupt M, Panzer R, Emmert S. Erythema multiforme, Stevens-Johnson syndrome/toxic epidermal necrolysis - diagnosis and treatment. J Dtsch Dermatol Ges. 2020;18(6):547-553. doi: 10.1111/ddg.14118.
5. Charlton OA, Harris V, Phan K, Mewton E, Jackson C, Cooper A. Toxic Epidermal Necrolysis and Steven-Johnson Syndrome: A Comprehensive Review. Adv Wound Care (New Rochelle). 2020;9(7):426-439. doi: 10.1089/wound.2019.0977.
Jacobsen A, Olabi B, Langley A, Beecker J, Mutter E, Shelley A, et al. Systemic interventions for treat-ment of Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome. Cochrane Database Syst Rev. 2022;3(3):CD013130. doi: 10.1002/14651858.
Shanbhag SS, Chodosh J, Fathy C, Goverman J, Mitchell C, Saeed HN. Multidisciplinary care in Stevens-Johnson syndrome. Ther Adv Chronic Dis. 2020;11:2040622319894469.
doi: 10.1177/2040622319894469.
DenAdel MA, Hendrickson SE, Fuchs E. Stevens Johnson Syndrome: Past, Present, and Future Directions Gynecologic Manifestations and Management in SJS/TEN. Front Med (Lausanne). 2022;9:874445. doi: 10.3389/fmed.2022.874445
Tuma F, McKeown DG, Al-Wahab Z. Rectovaginal Fistula [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK535350/
Gulanikar A, Abrol A, Sagar S. Study of genital manifestations of Stevens Johnson Syndrome/Toxic Epidermal Necrolysis. Indian J Sex Transm Dis AIDS. 2022;43(1):39-42. doi: 10.4103/ijstd.IJSTD_61_19.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Journal of Pakistan Association of Dermatologists
This work is licensed under a Creative Commons Attribution 4.0 International License.
