Stevens-Johnson Syndrome/ Toxic Epidermal Necrolysis Overlap Induced by Concurrent Phenytoin and Quetiapine Administration: A Case Report
DOI:
https://doi.org/10.66344/jpad.v36i2.3417Keywords:
Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, Drug Induced Hypersensitivity, Quetiapine, Phenytoin, Antipsychotic agents, Quetiapine fumarateAbstract
Steven Johnson syndrome (SJS) is a rare mucocutaneous drug reaction characterized by epidermal necrosis and detachment. Although both phenytoin and quetiapine have been individually associated with SJS, their concurrent administration is uncommon.
A 61 years old female who developed painful erythematous patches followed by blistering and mucosal erosion markedly seen on the back, face, proximal limbs and trunk after a single dose of taking both the drugs together for the first time. The clinical features and extent were consistent with SJS/TEN overlap. The Severity of Illness Score for Toxic Epidermal Necrolysis (SCORTEN) was calculated of 4, indicating a high risk of mortality. Both the drugs were immediately discontinued and systemic steroids along with supportive treatment showed marked improvement in the patient.
This case highlights the potential for severe adverse effects due to co-administration of medicines. Early recognition and prompt withdrawal of the causative agents are key to preventing the side effects and enhancing the outcomes in drug induced SJS.
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