Abstract

MELLONI MAGNELLI, L.; PADRON FLORES, A. E.; LARRAZABAL AGUERREVERE, L.I.  and  SONY AVENDANO, B. N.. Toxical epidermal necrolysis related to the use of drugs: Case report. Cir. plást. iberolatinoam. [online]. 2008, vol.34, n.4, pp.305-312. ISSN 1989-2055.

Stevens Johnson Syndrome (SJS) has been defined as a vesiculobullous multiform erythema of the skin and other organs. It´s considered as initial stage of a dermal reaction in which the most severe form of presentation is Toxic Epidermal Necrolysis (TEN). This is an acute systemic inflammatory disease that involves more than 30% of epidermal detachment of the body surface. Etiologically it is related to the use of some drugs in 60% of the cases, besides herpes simplex, mycoplasma infection and some genetic factors. SJS has a sudden onset and can be preceded for a prodromous of malaise between 1-14 days. The most important clinical finding is a target erythematous and popular lesion that spreads centripetaly evolving into a central vesicle. Generally involves mucous membranes often oral, conjunctival and genital areas. SJS occasionally can develop to TEN, characterized by painful necrotic cutaneous lesions, epidermal loss and bullous lesions spreading to an extensive skin detachment, compromising vital functions, producing electrolyte inbalance, renal and ocular impairment, excessive energy expenditure and potential sepsis risk. We report a 3 years old male with diagnosis of viral flu; during his hospitalisation developed SJS/TEN with satisfactory clinical output. We emphasize the multifactorial ethiology of the disease where drugs and infection act as a synergic combine bringing the complexity of the case.

Keywords : Vesiculobullous erythema; Stevens Johnson syndrome; Toxic epidermal necrolysis; Skin drugs reaction.

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