Stevens-Johnson Syndrome: A Case Report on Acute Hypersensitivity Reaction and Management

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe, life-threatening conditions characterized by extensive epidermal necrosis and mucosal involvement. SJS is defined by less than 10% epidermal detachment, while TEN is associated with more than 30% detachment, and SJS-TEN overlap occurs between 10-30%. We present a case of an 11-year-old female with a diagnosis of SJS-TEN overlap syndrome. The patient presented with extensive rashes, headache, watery stools, and hematuria. The rashes initially appeared on her chest and spread to involve the face, limbs, and abdomen, with the development of black scabs that bled upon removal. Laboratory findings revealed leucocytosis, elevated liver enzymes, and increased C-reactive protein. Due to the acute nature of the symptoms, hematological investigations were prioritized. Based on clinical and laboratory findings, the diagnosis of SJS-TEN overlap was made. The patient was treated with intravenous Vancomycin, oral Azithromycin, Meropenem, Lipomadol, Lidocaine, Fusidic acid, and Ciprofloxacin ointment. Daily reviews showed significant healing of the lesions, with complete recovery of all lesions observed after approximately 50 days. Early diagnosis, appropriate medication, and expert care contributed to a positive outcome for the patient.