Stevens–Johnson/Toxic epidermal necrolysis overlap syndrome

Abstract

A diagnosis of Stevens–Johnson syndrome/toxic epidermal necrolysis overlap syndrome secondary to pharmacotherapy (cotrimoxazole) was established. Despite its usefulness for definitive diagnosis, a skin biopsy was not possible due to the low-resource setting. The patient was admitted and immediately started on intravenous fluids, intravenous ceftriaxone and methylprednisolone with slow regression of the lesions. The patient was discharged after 10 days with follow-up in the out-patient clinic. Stevens–Johnson syndrome/toxic epidermal necrolysis is a rare but severe and potentially life-threatening condition due to an immune-mediated hypersensitivity reaction. It can be triggered by infectious agents but, in paediatrics, medications are the most common precipitant factor. Diagnosis is mainly based on clinical history and physical examination. A timely diagnosis is vital so that urgent supportive care is initiated; withdrawing the offending agent and the latter aspect are crucial to improve prognosis, morbidity and mortality.