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DOI: 10.1055/s-0032-1330112
Stevens Johnson Syndrome—An Adverse Drug Reaction Occurred after Uncomplicated Removal of an Intracerebral Cavernous Hemangioma
Publication History
01 September 2011
02 March 2012
Publication Date:
14 January 2013 (online)
![](https://www.thieme-connect.de/media/jnlsa/2013S01/lookinside/thumbnails/10.1055-s-0032-1330112-1.jpg)
Abstract
Background Toxic epidermal necrolysis (TEN) is a rare, severe adverse drug reaction. Steven-Johnson syndrome (SJS) represents the milder end of the spectrum. The exact pathogenesis of TEN and SJS is still unknown. Many drugs, including prednisolone, cyclosporin, and intravenous immunoglobulin (IVIG), have been used in an attempt to halt the disease process. The use of phenytoin as a prophylactic anticonvulsant after brain surgery, particularly for brain tumors, is a common practice, regardless of whether the patient has a previous history of convulsions. This treatment policy assumes that the benefits exceed the risks.
Case In this paper, we describe a young patient who underwent a total removal of an intracerebral cavernous hemangioma following development of SJS after taking phenytoin postoperatively.
Conclusion We suggest that the practice of routine use of phenytoin following brain surgery should be re-evaluated because the treatment may be neither essential nor without side effects.
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References
- 1 WHO. International drug monitoring: the role of national centres. Tech Rep Ser WHO 1972; , no 498
- 2 Rawlins M, Thompson W. Mechanisms of adverse drug reactions. In: Davies D, , ed. Textbook of Adverse Drug Reactions. New York: Oxford University Press; 1991: 18-45
- 3 Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet 2000; 356 (9237) 1255-1259
- 4 Gomes ER, Demoly P. Epidemiology of hypersensitivity drug reactions. Curr Opin Allergy Clin Immunol 2005; 5 (4) 309-316
- 5 Stevens AM, Johnson FC. A new eruptive fever associated with stomatitis and ophthalmia: report of two cases in children. Arch Pediatr Adolesc Med 1922; 24 (6) 526-533
- 6 Habif TP. Clinical Dermatology. 3rd ed. St Louis: Mosby-Year Book; 1996: 570-572
- 7 Donta-Bakoyianni K, Mitsea AG, Deodoropoulou-Papadimitriou K. Stevens-Johnson syndrome: case presentation. J Clin Pediatr Dent 2002; 27 (1) 71-76
- 8 Auquier-Dunant A, Mockenhaupt M, Naldi L, Correia O, Schröder W, Roujeau JC. SCAR Study Group. Severe Cutaneous Adverse Reactions. Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study. Arch Dermatol 2002; 138 (8) 1019-1024
- 9 Rzany B, Mockenhaupt M, Baur S , et al. Epidemiology of erythema exsudativum multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis in Germany (1990-1992): structure and results of a population-based registry. J Clin Epidemiol 1996; 49 (7) 769-773
- 10 Roujeau J-C, Kelly JP, Naldi L , et al. Medication use and the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis. N Engl J Med 1995; 333 (24) 1600-1607
- 11 Mockenhaupt M, Viboud C, Dunant A , et al. Stevens-Johnson syndrome and toxic epidermal necrolysis: assessment of medication risks with emphasis on recently marketed drugs. The EuroSCAR-study. J Invest Dermatol 2008; 128 (1) 35-44
- 12 Cotter JB. Methazolamide-induced Stevens-Johnson syndrome: a warning!. Arch Ophthalmol 1998; 116 (1) 117
- 13 Tay YK, Huff JC, Weston WL. Mycoplasma pneumoniae infection is associated with Stevens-Johnson syndrome, not erythema multiforme (von Hebra). J Am Acad Dermatol 1996; 35 (5 Pt 1) 757-760
- 14 Barvaliya M, Sanmukhani J, Patel T, Paliwal N, Shah H, Tripathi C. Drug-induced Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS-TEN overlap: a multicentric retrospective study. J Postgrad Med 2011; 57 (2) 115-119
- 15 Kroonen LM. Erythema multiforme: case report and discussion. J Am Board Fam Pract 1998; 11 (1) 63-65
- 16 Guibal F, Bastuji-Garin S, Chosidow O, Saiag P, Revuz J, Roujeau JC. Characteristics of toxic epidermal necrolysis in patients undergoing long-term glucocorticoid therapy. Arch Dermatol 1995; 131 (6) 669-672
- 17 Paul C, Wolkenstein P, Adle H , et al. Apoptosis as a mechanism of keratinocyte death in toxic epidermal necrolysis. Br J Dermatol 1996; 134 (4) 710-714