Stevens-Johnson syndrome with overlapping features of DRESS syndrome: A report of two cases

Stevens-Johnson syndrome and drug reaction with eosinophilia and systemic symptoms are severe cutaneous adverse reactions to drugs that are generally considered distinct entities. In addition to identifying the offending medication, distinguishing between these diagnoses is important, as they have d...

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Main Authors: Laura D Chin, Michael L MacGillivary, Kerri S Purdy, Carly Kirshen
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X241307097
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author Laura D Chin
Michael L MacGillivary
Kerri S Purdy
Carly Kirshen
author_facet Laura D Chin
Michael L MacGillivary
Kerri S Purdy
Carly Kirshen
author_sort Laura D Chin
collection DOAJ
description Stevens-Johnson syndrome and drug reaction with eosinophilia and systemic symptoms are severe cutaneous adverse reactions to drugs that are generally considered distinct entities. In addition to identifying the offending medication, distinguishing between these diagnoses is important, as they have differing treatment regimens and prognoses. Distinction between severe cutaneous adverse reactions, particularly in the early stages of disease, can be difficult, and overlapping conditions have been reported in the literature. We present two cases of severe cutaneous adverse reaction, one following initiation of carbamazepine and the other lamotrigine, with extensive mucosal involvement and epidermal detachment, initially diagnosed as Stevens-Johnson syndrome. Despite the use of cyclosporine and repeated doses of etanercept, both cases evolved to have significant edema of the face and extremities, palmar and plantar involvement, and rapid response to systemic corticosteroids, which is more in-keeping with drug reaction with eosinophilia and systemic symptoms. We aim to help clinicians gain awareness of Stevens-Johnson syndrome/drug reaction with eosinophilia and systemic symptoms overlap which may aid diagnosis and guide treatment.
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spelling doaj-art-59dff004140e4729a7364d0f94992b692024-12-19T14:03:25ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2024-12-011210.1177/2050313X241307097Stevens-Johnson syndrome with overlapping features of DRESS syndrome: A report of two casesLaura D Chin0Michael L MacGillivary1Kerri S Purdy2Carly Kirshen3Division of Dermatology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, CanadaDivision of Dermatology, Department of Medicine, Georges-L-Dumont University Hospital Centre, Moncton, NB, CanadaDivision of Dermatology, Department of Medicine, Dalhousie University, Halifax, NS, CanadaDivision of Dermatology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, CanadaStevens-Johnson syndrome and drug reaction with eosinophilia and systemic symptoms are severe cutaneous adverse reactions to drugs that are generally considered distinct entities. In addition to identifying the offending medication, distinguishing between these diagnoses is important, as they have differing treatment regimens and prognoses. Distinction between severe cutaneous adverse reactions, particularly in the early stages of disease, can be difficult, and overlapping conditions have been reported in the literature. We present two cases of severe cutaneous adverse reaction, one following initiation of carbamazepine and the other lamotrigine, with extensive mucosal involvement and epidermal detachment, initially diagnosed as Stevens-Johnson syndrome. Despite the use of cyclosporine and repeated doses of etanercept, both cases evolved to have significant edema of the face and extremities, palmar and plantar involvement, and rapid response to systemic corticosteroids, which is more in-keeping with drug reaction with eosinophilia and systemic symptoms. We aim to help clinicians gain awareness of Stevens-Johnson syndrome/drug reaction with eosinophilia and systemic symptoms overlap which may aid diagnosis and guide treatment.https://doi.org/10.1177/2050313X241307097
spellingShingle Laura D Chin
Michael L MacGillivary
Kerri S Purdy
Carly Kirshen
Stevens-Johnson syndrome with overlapping features of DRESS syndrome: A report of two cases
SAGE Open Medical Case Reports
title Stevens-Johnson syndrome with overlapping features of DRESS syndrome: A report of two cases
title_full Stevens-Johnson syndrome with overlapping features of DRESS syndrome: A report of two cases
title_fullStr Stevens-Johnson syndrome with overlapping features of DRESS syndrome: A report of two cases
title_full_unstemmed Stevens-Johnson syndrome with overlapping features of DRESS syndrome: A report of two cases
title_short Stevens-Johnson syndrome with overlapping features of DRESS syndrome: A report of two cases
title_sort stevens johnson syndrome with overlapping features of dress syndrome a report of two cases
url https://doi.org/10.1177/2050313X241307097
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