Abstract

MENDOZA-SABILLON, DE; ANDRADE-ROMERO, JR; IZAGUIRRE-ESCOTO, L  and  SANCHEZ-SIERRA, LE. Stevens-Johnson syndrome with evolution to toxic epidermal necrolysis secondary to rare drug: A case report. Rev. argent. dermatol. [online]. 2017, vol.98, n.1, pp.13-20. ISSN 1851-300X.

The Stevens-Johnson syndrome and the toxic epidermal necrolysis are a type III hypersensitivity reaction of the Gell and Coombs classification, considered to be of immunological origin in which massive apoptosis of keratinocytes occurs in the epidermis, causing scaling and appearance of scalded skin. It is caused by agents of infectious and pharmacological (the most common) etiology; it may be associated with malignancy or idiopathic; the SSJ has an incidence of 1.2 to 6 cases per million people per year, being NET the least common. They differ by the extent of skin lesions, but both are characterized by mucosal affectation, airway, digestive system, and urogenital tract involvement. It is presented the case of a 84-years-old patient with history of onychomycosis and athlete's foot, who started antimycotic treatment with fluconazole, developing cutaneous manifestations of blisters on the skin and mucous membranes, vesicular lesions in his right and left arms, chest and left hemiabdomen seven days later; after his hospital admittance, the patient evolved with violaceous arches in skin, desquamation, positive sign of Nikolsky, and affectation of the airways. The diagnosis and timely treatment is fundamental to reverse the natural evolution of this disease and multidiciplinary treatment ensures a better evolution of signs and symptoms.

Keywords : Stevens-Johnson syndrome; toxic epidermal necrolysis; fluconazole; methylprednisolone.