engleski

Stevens-Johnson syndrome induced by naproxene - a case report

Aim: Stevens-Johnson syndrome (SJS) is a serious clinical condition that involves the skin and the mucous membranes. It can occur after infection or more often as a drug reaction, but often it is idiopathic. Typical manifestation is generalized rash distributed mainly on the trunk and consisting of target lesions with hemorrhagic maculopapule in the center. It is important to follow up changes on the patient’s skin because if the skin begins to blister and peel in more than 10% of the body surface area, it means progression to toxic epidermal necrolysis (TEN), a life-threatening condition with serious complications such as renal failure, sepsis and death. Case report: We report a case of a 79- year-old male patient who presented with generalized rash accompanied by fever and chills, multiple oral erosions, painful swallowing, conjunctivitis and hyperglycemia. Ten days prior to the occurrence of symptoms, he began using naproxen for hip pain. The drug was immediately discontinued, and the patient was treated with high dose of intravenous methylprednisolone along with symptomatic and supportive therapy. On the third day his skin started to detach on his trunk, and the condition progressed to SJS/TEN overlap but not to true TEN. Slow taper or corticosteroids resulted in complete recovery. Conclusion: Stevens-Johnson syndrome is a serious side effect of various drugs. This syndrome should be kept in mind when prescribing naproxen, as it is not a rare reaction on this drug. Multidisciplinary approach and a careful follow-up of patients is essential for successful treatment.

naproxene ; drug rash ; Stevens-Johnson syndrome

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