Stevens-Johnson syndrome in a patient with epilepsy and Parkinson's disease: Case report
DOI:
https://doi.org/10.33448/rsd-v12i1.39133Keywords:
Rash; Pharmacodermia; Erythema multiforme.Abstract
Steven-Johnson Syndrome commonly occurs as an idiosyncratic reaction to systemic medications such as antibiotics, antiepileptics, and nonsteroidal anti-inflammatory drugs. It can also be triggered by non-pharmacological causes. It is a pathology with a significant impact on public health due to the high mortality rate. The clinical picture presents nonspecific symptoms, such as fever, odynophagia and itchy eyes. However, it is characterized by initial erythematous and livid macules, which involve the skin of the pre-sternal trunk and face, and may affect the palms of the hands and soles of the feet. Diagnosis of the syndrome requires collection of a complete clinical history, with special attention to drug exposure, thorough physical examination of the skin lesions, determination of the affected skin area, evaluation of mucosal involvement and complementary tests, such as skin biopsy for histopathological study. Prognosis is related to rapid identification of the causative drug and its discontinuation, not related to dose or type of drug. A case of Stevens-Johnson Syndrome is reported in a 70-year-old patient with epilepsy and Parkinson's disease, in northern Brazil, emphasizing the clinical characteristics and the adopted treatment.
References
Beken, B., et al. (2017). Oxcarbazepine-induced Stevens–Johnson syndrome: a pediatric case report. Oxford Medical Case Reports, 2017(6), omx028.
Bloom, R., & Amber, K. T. (2017). Identifying the incidence of rash, Stevens-Johnson syndrome and toxic epidermal necrolysis in patients taking lamotrigine: a systematic review of 122 randomized controlled trials. Anais Brasileiros de Dermatologia, 92, 139-141.
Bulisani, A. C. P., et al. (2006). Síndrome de Stevens-Johnson e necrólise epidérmica tóxica em medicina intensiva. Revista Brasileira de Terapia Intensiva, 18, 292-297.
Cabreira, V., & Massano, J. (2019). Doença de Parkinson: Revisão Clínica e Atualização. Acta Médica Portuguesa, 32(10).
Cai, Z. R., et al. (2020). Toxic epidermal necrolysis associated with pembrolizumab. Journal of Oncology Pharmacy Practice, 26(5), 1259-1265.
Creamer, D., et al. (2016). UK guidelines for the management of Stevens–Johnson syndrome/toxic epidermal necrolysis in adults 2016. British Journal of Dermatology, 174(6), 1194-1227.
De Oliveira Costa, L. L., et al. (2020). Update on epilepsy: literature review. Rev Med., 99(2), 170-81.
Fakoya, A. O. J., et al. (2018). Stevens-Johnson syndrome and toxic epidermal necrolysis; extensive review of reports of drug-induced etiologies, and possible therapeutic modalities. Open access Macedonian journal of medical sciences, 6(4), 730.
Fouchard, N., et al. (2000). SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. Journal of Investigative Dermatology, 115(2), 149-153.
Grünwald, P., et al. (2020). Erythema multiforme, Stevens‐Johnson syndrome/toxic epidermal necrolysis–diagnosis and treatment. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 18(6), 547-553.
Lipový, B., et al. (2021). Case Report: Wound Closure Acceleration in a Patient With Toxic Epidermal Necrolysis Using a Lyophilised Amniotic Membrane. Frontiers in Bioengineering and Biotechnology, 9, 649317.
Bomfim Lopes, A. C. M., et al. (2022). Síndrome de Stevens Johnson e necrólise epidérmica tóxica–a importância do cirurgião dentista no diagnóstico Stevens johnson syndrome and toxic epidermal necrolysis-the importance of the dental surgeon in the diagnosis. Brazilian Journal of Health Review, 5(3), 10052-10063.
Mifsud, N. A., et al. (2021). Carbamazepine induces focused T cell responses in resolved Stevens-Johnson syndrome and toxic epidermal necrolysis cases but does not perturb the immunopeptidome for T cell recognition. Frontiers in Immunology, 12, 653710.
Mockenhaupt, M., et al. (2005). Risk of Stevens–Johnson syndrome and toxic epidermal necrolysis in new users of antiepileptics. Neurology, 64(7), 1134-1138.
Neto, H. C., et al. (2019). Síndrome de Stevens-Johnson associada a fenitoína em pós-operatório de hemorragia intraparenquimatosa cerebral: relato de caso. Fag Journal Of Health (FJH), 1(4), 169-184.
Pereira, A. S., et al. (2018). Metodologia da pesquisa científica. FSM. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_C
Rocha, L. P. S. (2018). Relato de caso e revisão da literatura de Síndrome de Stevens-Johnson associada a episódio de varicela. Arquivos Catarinenses de Medicina, 47(3), 226-234.
Roviello, C. F., et al. (2019). Manifestações e tratamento da necrólise epidérmica tóxica e da síndrome de Stevens Johnson/Manifestations and treatment of toxic epidermic necrolysis and Stevens Johnson's syndrome/Manifestaciones y tratamiento de la necrolisis epidérmica tóxica... Journal Health NPEPS, 4(1), 319-329.
Santos, G. F., et al. (2022). Doença de Parkinson: Padrão epidemiológico de internações no Brasil. Research, Society and Development, 11(1).
Shanbhag, S. S., et al. (2020). Multidisciplinary care in Stevens-Johnson syndrome. Therapeutic Advances in Chronic Disease, 11, 2040622319894469.
Wong, A., et al. (2016). Stevens-Johnson syndrome and toxic epidermal necrolysis: a review. Revista da Associação Médica Brasileira, 62, 468-473.
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Copyright (c) 2023 Joanilson Andrade Freire Junior; João Vitor Vieira dos Santos; João Vitor Nunes Climaco; Ana Caroline Gonçalves de Sá Novaes; Zuleika Santiago de Medeiros Carneiro; Nilo Fernandes da Costa; Virgílio Ribeiro Guedes
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