CASE HISTORY – September 2008

Stevens-Johnson syndrome


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Stevens-Johnson syndrome, an acute inflammatory vesiculobullous reaction of the skin and mucous membranes is rare, one to two cases per 1 million inhabitants. On May 17, 2004, a 28-year-old man was admitted to the department of infectious diseases, University of Tartu, with the diagnosis of measles. He had high fever, maculo-papularrash, and there were observed a few vesicles as well. The patient has allergy for pollen. Two weeks before he fell ill he had taken sulfazalasine for  spondylarthritis (HLA B27 positive). When rash appeared he stopped the treatment. Skin lesions and mucous eruption progressed approximately during 5 days. Ophthalmologic consultation was needed which allowed to diagnose keratoconjunctivitis. Treatment was supportive. Corticosteroids were only used on the first two days. On the 18th day of admission the patient was discharged in good condition, but ophthalmologic consultation was still recommended.