Venus Hospital, Mid Baneshwor, Kathmandu, Nepal.
Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2020 Oct 15;58(230):801-804. doi: 10.31729/jnma.5308.
Stevens-Johnson syndrome and Toxic Epidermal Necrolysis are acute mucocutaneous reactions hallmark of which is widespread necrosis and detachment of epidermis. SJS/TEN fall under the single disease spectrum with an incidence rate of 1.0 to 6.0 per 1000000 and 0.4 to 1.2 per 1000000 respectively. Here, we present a case of a 46 years female who developed a generalized erythematous rash over her body, 26 days after being exposed to phenytoin and sodium valproate. Given the strong association between SJS and antiepileptic drugs, and the usual presentation being within the first eight weeks of exposure to susceptible medications; we diagnosed her with SJS. Phenytoin and sodium valproate was withdrawn and she was managed with antihistamines and corticosteroids. She improved significantly within 15 days of our intervention. The mortality rates for SJS and TEN are up to 10% and 30-50% respectively. Early identification of SJS, discontinuation of triggering medicines, and prompt initiation of supportive therapy improve the prognosis. Keywords: adverse drug reactions;antiepileptic drugs;case report;stevens-johnson syndrome.
史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症是急性黏膜皮肤反应,其特征为广泛的表皮坏死和脱落。SJS/TEN 属于单一疾病谱,发病率分别为每 1000000 人 1.0 至 6.0 和每 1000000 人 0.4 至 1.2。在这里,我们介绍了一位 46 岁女性的病例,她在接触苯妥英钠和丙戊酸钠 26 天后全身出现红斑疹。鉴于 SJS 与抗癫痫药物之间存在很强的关联,且通常在接触易感药物的前 8 周内出现;我们诊断她患有 SJS。停用苯妥英钠和丙戊酸钠,并给予抗组胺药和皮质类固醇治疗。在我们干预的 15 天内,她的病情显著改善。SJS 和 TEN 的死亡率分别高达 10%和 30-50%。早期识别 SJS、停用诱发药物以及及时启动支持性治疗可改善预后。关键词:药物不良反应;抗癫痫药物;病例报告;史蒂文斯-约翰逊综合征。