Reactions 1346 - 9 Apr 2011

SCarbamazepine

Stevens-Johnson syndrome sparing skinpreviously affected by herpes zoster in a patientwith SLE: case report

A 39-year-old woman with systemic lupuserythematosus (SLE) developed Stevens-Johnsonsyndrome (SJS), sparing the skin previously affected byherpes zoster, following carbamazepine therapy forpostherpetic neuralgia.

The woman was diagnosed with SLE in 2003 anddeveloped herpes zoster in the right thoracoabdominalarea in 2007. Although the herpes zoster infection resolvedfollowing treatment with aciclovir, she continued toexperience a burning sensation in the affected area andcarbamazepine was initiated [dosage and route not stated].After 11 days, she developed conjunctival hyperaemia,painful erosions of the oral mucosa, purpuric macules andpatches and blistering, in addition to patchy skindetachment. Notably, the area affected by herpes zosterwas spared. A histological examination was consistent withSJS.

Carbamazepine was stopped and the woman’sprednisone dosage was increased. She continued receivingazathioprine along with supportive therapy andantibacterials. The eruption resolved. Her SLE subsequentlyworsened and she died of complications.

Author comment: "Based on the clinical presentation andpathology report, a diagnosis of [carbamazepine]-induced SJSwith a reverse isotopic phenomenon was established in apatient with SLE."Tenea D. Carbamazepine-induced Stevens-Johnson syndrome sparing the skinpreviously affected by herpes zoster infection in a patient with systemic lupuserythematosus: A reverse isotopic phenomenon. Case Reports in Dermatology 2:140-145, No. 2, 2010. Available from: URL: http://dx.doi.org/10.1159/000319628 -South Africa 803052548

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Reactions 9 Apr 2011 No. 13460114-9954/10/1346-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved