Zisis Vasileios, Papadopoulos Petros, Kyriakou Nikolaos, Charisi Christina, Poulopoulos Athanasios
Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Hospital Dentistry and Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Cureus. 2024 Jun 28;16(6):e63353. doi: 10.7759/cureus.63353. eCollection 2024 Jun.
Stevens-Johnson Syndrome (SJS) constitutes a rather uncommon, and rarely fatal hypersensitivity reaction that primarily impacts the skin and mucous membranes and in certain cases may be attributed to drug administration. The aim of this article is to present a case of etoricoxib-induced SJS in a 46-year-old, female patient. The patient presented herself, as a medical emergency, to the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, reporting pain, especially acute pain while eating certain foods, discomfort, dysphagia, and a wound in the left half of the hard palate. The clinical examination revealed a broad ulcer, in the left half of the hard palate as well as multiple ulcerations and erosions in the upper and lower lip. Her medical history was clear; however, the patient mentioned to have received etoricoxib, due to severe back pain, one day prior to our clinical examination. The patient received methylprednisolone 16 mg, twice per day, for two days, followed by methylprednisolone 8 mg, twice per day, for two more days. Her symptoms resigned and since the connection between etoricoxib and SJS was established, the patient was advised to avoid etoricoxib and be wary of adverse effects, when taking drugs especially non-steroidal anti-inflammatory medication. This is one of the first case reports in the literature, linking etoricoxib administration with the emergence of SJS, highlighting the importance of pharmacovigilance. The up-to-date registration of drug-induced adverse effects is of immense importance to protect future patients. SJS does not have a defined treatment strategy. Therefore, most patients are given supportive care and symptomatic treatment, which most commonly involves corticosteroids and antivirals such as acyclovir.
史蒂文斯 - 约翰逊综合征(SJS)是一种相当罕见且极少致命的超敏反应,主要影响皮肤和黏膜,在某些情况下可能归因于药物使用。本文旨在介绍一例46岁女性患者因服用依托考昔引发史蒂文斯 - 约翰逊综合征的病例。该患者作为急诊患者前往希腊塞萨洛尼基亚里士多德大学牙科学院口腔医学/病理学系就诊,自述疼痛,尤其是在食用某些食物时剧痛,伴有不适、吞咽困难以及硬腭左侧有一处创口。临床检查发现硬腭左侧有一个大面积溃疡,上下唇也有多处溃疡和糜烂。其病史无异常;然而,患者提到在我们临床检查前一天因严重背痛服用了依托考昔。患者接受了甲泼尼龙,首日16毫克,每日两次,共两天,随后8毫克,每日两次,再用两天。其症状消退,由于确定了依托考昔与史蒂文斯 - 约翰逊综合征之间的关联,建议患者避免使用依托考昔,并在用药尤其是使用非甾体抗炎药时警惕不良反应。这是文献中首批将依托考昔使用与史蒂文斯 - 约翰逊综合征的出现相联系的病例报告之一,凸显了药物警戒的重要性。及时记录药物引起的不良反应对于保护未来患者极为重要。史蒂文斯 - 约翰逊综合征没有明确的治疗策略。因此,大多数患者接受支持性护理和对症治疗,最常用的是皮质类固醇和抗病毒药物如阿昔洛韦。