"Allopurinol-Induced Stevens-Johnson Syndrome: A Case Report"

Allopurinol is a commonly prescribed xanthine oxidase inhibitor for the treatment of gout and hyperuricemia. While generally well tolerated, it is a major source of severe cutaneous adverse effects, including Stevens-Johnson Syndrome (SJS). SJS is an uncommon, potentially fatal mucocutaneous reaction that is frequently associated with high-dose therapy, renal impairment, or genetic predispositions like the HLA-B*58:01 variant. We present the case of a 62-year-old male with a history of gout and hypertension who experienced SJS one week after starting low-dose allopurinol (100 mg/day). The patient came with a high temperature, severe bullous eruptions, and erythematous rashes covering around 8% of the total body surface area. Leukocytosis and high C-reactive protein levels were found in the laboratory, but renal and hepatic function were normal. The patient was immediately taken off allopurinol and treated with systemic corticosteroids, intravenous fluids, antibiotics, and supportive care. Within 10 days, the patient had complete reepithelialization and was discharged in stable condition. This example demonstrates that allopurinol-induced SJS can develop at low dosages and without identified risk factors. It emphasizes the need of early detection, immediate removal of the offending agent, and aggressive supportive management. The instance also emphasizes the importance of clinical monitoring and pharmacogenetic screening, especially in susceptible populations