• Title/Summary/Keyword: Stevens-Johnson syndrome (SJS)

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Long-term Complications of Stevens-Johnson Syndrome on Permanent Teeth : A Case Report

  • Dabin Kim;Myeongkwan Jih;Nanyoung Lee
    • Journal of Korean Dental Science
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    • v.17 no.2
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    • pp.75-83
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    • 2024
  • Stevens-Johnson syndrome (SJS) is a severe adverse cutaneous drug reaction seen rarely in clinical practice. Although relatively rare, the condition can be fatal. Mainly, it is caused by side effects of certain medications. Previous reports have associated Stevens-Johnson syndrome with abnormal root development, but the other long-term dental complications have rarely been reported. In this case, the patient developed SJS at the age of 5, and abnormal root development of the maxillary and mandibular first molars and mandibular incisors was observed, as well as impaction of the mandibular canine and enamel hypomineralization of multiple teeth. Accordingly, appropriate restorative treatment and orthodontic treatment were performed, and the clinical characteristics of this symptoms and its treatment were discussed in more detail. We aim to highlight the need for dentists to be aware of the potential dental complications of SJS and to enable early diagnosis and management of the condition to avoid undesirable sequelae.

Stevens-Johnson syndrome and abuse of anabolic steroids

  • Cocca, Serena;Viviano, Massimo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.1
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    • pp.57-60
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    • 2017
  • Stevens-Johnson syndrome (SJS) is characterized by mucocutaneous tenderness and typical hemorrhagic erosions, erythema and epidermal detachment presenting as blisters and areas of denuded skin. SJS is often observed after drug use as well as after bacterial or viral infections. Several drugs are at high risk of inducing SJS, but there are no cases in the English literature regarding anabolic steroid use triggering SJS. In our paper, we describe a case in which use of anabolic androgenic steroids (AAS) was associated with SJS. The patient participated in competitive body-building and regularly took variable doses of AAS. Initial symptoms (headache, weakness, pharyngodynia, and fever) were ignored. After a week he presented to the Emergency Department with a burning sensation on the mouth, lips, and eyes. Painful, erythematous, maculopapular, and vesicular lesions appeared all over the body, including on the genitals. During hospitalization, he also developed a cardiac complication. The patient had not taken any drugs except AAS.

Mycoplasma pneumoniae-induced Stevens-Johnson syndrome without skin manifestations (마이코플라즈마 감염에 의한 피부 병변을 동반하지 않은 Stevens-Johnson 증후군 1예)

  • Choi, Sun-Hee;Lee, Yu-Min;Rha, Yeong-Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.247-250
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    • 2009
  • Stevens-Johnson syndrome (SJS) presents with widespread blisters, erythematous or purpuric macules, and one or more mucous membrane erosions. Various etiologic factors, including infection, vaccination, drug administration, systemic diseases, physical agents, and food have been implicated as causes of SJS. Mycoplasma pneumoniae is the most common infectious agent to cause SJS in children. In recent literature, M. pneumoniae-induced SJS with mucositis that lacks the typical target lesions has been described. We report a case of a 6-year-old boy with swelling, peeling of the lips, and red eyes with photosensitivity. On physical examination, he showed severe oral mucositis and conjunctivitis with no evidence of skin lesions. Mycoplasma antibody, which was positive with titers of more than 1:2,560. For patients presenting with fever and mucositis of unknown origin, M. pneumoniae should be considered.

Early surgical correction of microstomia following Stevens-Johnson syndrome

  • Ki, Sae Hwi;Jo, Gang Yeon;Ma, Sung Hwan;Choi, Matthew Seung Suk
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.119-122
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    • 2020
  • Stevens-Johnson syndrome (SJS) is a rare disease in which extensive toxic epidermolysis occurs after medication. Skin and mucous membranes are involved in about 90% of SJS cases, and webbing of mouth corners (microstomia) may occur when they are affected. Few reports have been issued on microstomia in SJS, and no consensus has been reached regarding treatment methods, timings, or results. We encountered a case of microstomia following SJS after ofloxacin medication in a 22-year-old woman treated by commissuroplasty using a lozenge-shaped excision. We present an appropriate correction method and surgical timing for microstomia following SJS.

A bioinformatic approach to identify pathogenic variants for Stevens-Johnson syndrome

  • Muhammad Ma'ruf;Justitia Cahyani Fadli;Muhammad Reza Mahendra;Lalu Muhammad Irham;Nanik Sulistyani;Wirawan Adikusuma;Rockie Chong;Abdi Wira Septama
    • Genomics & Informatics
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    • v.21 no.2
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    • pp.26.1-26.9
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    • 2023
  • Stevens-Johnson syndrome (SJS) produces a severe hypersensitivity reaction caused by Herpes simplex virus or mycoplasma infection, vaccination, systemic disease, or other agents. Several studies have investigated the genetic susceptibility involved in SJS. To provide further genetic insights into the pathogenesis of SJS, this study prioritized high-impact, SJS-associated pathogenic variants through integrating bioinformatic and population genetic data. First, we identified SJS-associated single nucleotide polymorphisms from the genome-wide association studies catalog, followed by genome annotation with HaploReg and variant validation with Ensembl. Subsequently, expression quantitative trait locus (eQTL) from GTEx identified human genetic variants with differential gene expression across human tissues. Our results indicate that two variants, namely rs2074494 and rs5010528, which are encoded by the HLA-C (human leukocyte antigen C) gene, were found to be differentially expressed in skin. The allele frequencies for rs2074494 and rs5010528 also appear to significantly differ across continents. We highlight the utility of these population-specific HLA-C genetic variants for genetic association studies, and aid in early prognosis and disease treatment of SJS.

Stevens-Johnson Syndrome Induced by Carbamazepine Treatment in a Patient Who Previously Had Carbamazepine Induced Pruritus - A Case Report -

  • Bae, Hyun Min;Park, Yoo Jung;Kim, Young Hoon;Moon, Dong Eon
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.80-83
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    • 2013
  • Stevens-Johnson syndrome (SJS) is a rare but life-threatening skin reaction disease and carbamazepine is one of its most common causes. We report a case of SJS secondary to carbamazepine in a patient with previous pruritus due to carbamazepine which was given for treatment of trigeminal neuralgia. We would like to caution all providers that carbamazepine readministration should be avoided in the patient with a previous history of SJS or adverse skin reaction. In addition, we strongly recommend gradual titration when initiating treatment with carbamazepine.

A Case of Myasthenia Gravis Combined with Mediastinal Leiomyosarcoma and Stevens-Johnson Syndrome (종격 평활근육종 및 Stevens-Johnson증후군과 동반된 중증 근무력증 1예)

  • Lee, Dong-Kuck;Kweon, Young-Mi
    • Annals of Clinical Neurophysiology
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    • v.6 no.1
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    • pp.43-47
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    • 2004
  • We report a case of 36-year-old woman with myasthenia gravis (MG) combined with mediastinal leiomyosarcoma (LMS) and Stevens-Johnson syndrome (SJS). She was admitted to ICU with the symptoms of acute onset headache, diplopia, ptosis, dysphagia, general weakness, and respiratory difficulty for several days. Physical examination revealed tachypnea, decreased breath sounds and dullness to percussion in right lower chest. Neurologic examination showed ptosis, diplopia, decreased gag reflexes, and generalized proximal weakness. Laboratory studies revealed increased serum acetylcholine receptor antibodies and positive Tensilon test. Chest CT showed a huge mass in the right middle mediastium but no evidence of thymic enlargement. Mediastinal LMS was diagnosed by ultrasound-guided needle biopsy. The myasthenic symptoms were fluctuated in spite og intravenous immunoglobulin, plasmapheresis, and corticosteroid. During therapy, SJS developed. She died 4 months after the onset of the myasthenic symptoms despite the chemotherapy for LMS.

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A Case of Stevens-Johnson Syndrome Plus Vanishing Bile Duct Syndrome Associated with Ibuprofen Use (Stevens-Johnson Syndrome 환아에서 발생한 Ibuprofen과 연관된 Vanishing Bile Duct Syndrome 1례)

  • Choi, Jee Yee;Kim, Su Young;Byun, Soon Ok;Park, Jae Hong
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1146-1149
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    • 2002
  • Acute vanishing bile syndrome is a cause of progressive cholestasis. It is most often drug or toxin related. It's pathogenesis is unknown. Stevens-Johnson syndorme is a well-recognized immune complex-mediated hypersensitivity reaction. It is induced by drug or infection. It has classic systemic, mucosal, and dermatologic manifestations. We report a case of a 14 years old female suffering from Stevens-Johnson syndrome plus vanishing bile duct syndrome associated with ibuprofen use. We report the case with a brief review of its related literature.

Erythema Multiforme and Stevens-Johnson Syndrome : Case Reports (다형홍반과 스티븐스-존슨 신드롬의 증례보고)

  • Jung, Won;Lee, Kyung-Eun;Byun, Jin-Seok;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.36 no.4
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    • pp.207-213
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    • 2011
  • Painful, ulcerative lesions of various systemic disease can affect the oral mucosa membrane at first. If you don't consider the skin lesion, followed or accompanied by oral mucosa, you are likely to fail in differential diagnosis. In this cases, we introduced erythema multiforme and Stevens-Johnson syndrome(SJS) patients with painful, ulcerative lesions on oral mucosa and skin. Also we review oral mucosal diseases come with the skin lesions.

A Systematic Review on the Causative Medicines for Stevens-Johnson Syndrome (스티븐스-존슨증후군을 유발하는 주요 의약품별 위험도에 대한 체계적 문헌고찰)

  • Kwon, Kyoung-Eun;Jung, Sun-Young;Jung, Hyun-Joo;Kim, Bong Gi;Park, Byung-Joo
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.4
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    • pp.344-364
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    • 2013
  • Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune-complex-mediated hypersensitivity reactions that predominantly involve skin and mucous membranes. Despite the low incidence, both are considered medical emergencies as the mortality rate has been estimated at 30-50%. Although as many as half of cases are idiopathic, several drugs have been implicated as main cause of SJS/TEN. This review therefore aimed to identify drugs that were potentially associated with SJS/TEN and compare the relative risk of the medications. Method: A comprehensive search was performed using MEDLINE, EMBASE and 5 Korean databases. We defined study drugs as non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, antiepileptics, and allopurinol. Only epidemiologic studies investigating associations between the above drugs and drug-induced SJS/TEN were included. Two reviewers independently selected and evaluated candidate papers and extracted odds ratios or incidence rates. Meta-analysis was performed only for drugs that were reported from 4 or more studies. Results: We found 8 case-control studies, 3 cohort studies and 1 RCT. The ranges of adjusted ORs were 0.6-34.0 for NSAIDs, 1.6-302.0 for antiepileptics, 0.3-10.0 for antibiotics and 1.0-187.0 for allopurinol. The drug with the highest incidence of SJS/TEN was carbamazepine (40 persons/1,000 DDD). Conclusion: Finally, the risk was highest in first 8 weeks after onset of treatment in all drugs.