Azithromycin-Induced Stevens-Johnson Syndrome in a Patient With SARS-CoV-2 and End-Stage Renal Disease

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are a spectrum of immune-mediated mucocutaneous injuries often due to an adverse reaction to medication or infection. Numerous medications have been associated with SJS, with abacavir, allopurinol, aromatic antiepileptic drugs, minocycline, proton pump inhibitors, and sulfasalazine being the most common. Additionally, there have been several case reports of SJS associated with SARS-CoV-2 infection. The clinical presentation of SJS usually includes atypical targets or purpuric macules, along with oral mucosal involvement. Herein, we present a case of SJS with primary oral mucosal involvement in a patient with end-stage renal disease (ESRD) due to polycystic kidney disease, recent SARS-CoV-2 infection, and azithromycin exposure.