Use of Cyclosporine for the Treatment of Stevens- Johnson syndrome and Toxic Epidermal Necrolysis Induced by Carbamazepine- A Case Report

Abstract

Stevens Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare, potentially life threatening, severe mucocutaneous adverse reactions characterised by extensive epidermal detachment, erosion of mucosa and severe constitutional symptoms. However, the use of Carbamazapine may be associated with a plethora of adverse effects, the most serious being SJS/TEN, wherein the patient typically presents with fever, skin eruption and mucosal involvement. It occurs between 1/1,000 and 1/10,000 new exposures to the drug. Here, the authors report a case of severe life threatening SJS/TEN induced by Carbamazepine in a three-year-old boy who presented with high grade fever, skin rash and all mucosal involvement. This condition is best approached with immediate discontinuation of offending drug and prompt administration of oral cyclosporine. The case is being reported to emphasise the need for timely diagnosis and prompt treatment with Cyclosporin for successful outcome as it can cause irreversible organ damage or death if untreated early.

Keywords

• antiepileptic
• immunomodulator
• pseudo-nikolsky signs
• world health organization