SÍNDROME DE STEVENS-JOHNSON SECUNDARIO A ALOPURINOL: PRESENTACIÓN DE UN CASO. HOSPITAL SANTO TOMÁS. SEPTIEMBRE 2005.

José Isaac Latorraca; Joel Moreno Ríos; Yolanda Rivera

Submitted October 30, 2024

Published 2026-04-06

Artículos de Investigación

Vol. 19 No. 1 (2006): Revista Médico Cientifica

STEVENS-JOHNSON SYNDROME SECONDARY TO ALLOPURINOL: A CASE REPORT. SANTO TOMAS HOSPITAL. SEPTEMBER 2005.

José Isaac Latorraca⁺⁻
Joel Moreno Ríos⁺⁻
Yolanda Rivera⁺⁻

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Published: 2026-04-06

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Abstract

Stevens-Johnson's syndrome is a little frequenl"pathology, with a worldwide incidence average of 1,2 - 6 cases by 1 000000 inhabitants, like idiosyncratic reaction to the ingestion of determined food, infections or medicines. We are presenting a 46 years old male patient who goes by clinical picture characterized by the appearance of papuloerythematic, vesicular and pustules injuries in lips, oral cavity, extremities and glande; followed by fever, periorbitary edema, purulent conjuntivitis and conjuntival hemorrhage; the picture is developed 24 hours after. the ingestion of Alopurinol, prescribed by gout picture of first right toe. No other antecedent of importance. Dermatology and ophtalmology confirm the extension of the injury in the patient of 10 %, and the presence of bilateral symblepharon. Diagnosis of Stevens-Johnson's syndrome is made to him.

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References

Berger T Skin, Hair, & Nails. In: Tierney L, McPhee S, Papadakis M, editors. Current Medical Diagnosis & Treatment. USA: McGraw-Hill/Appleton & Lange; 2005. p.105.
World Health Organization. WHO Drug Information. WHO Drug Information. [serial on the internet] 2004 [cited 2005 Sep 23] Vol 18, No. 3.[about 2 p.] Available from: http:// whqlibdoc.who.inUdruginfo/18_3_2004.pdf
Estadistica de Reacción adversas medicamentosas según Año, CNFV, 1998-2005. Ministerio de Salud. República de Panamá.
Paul C, Wolkenstein P, Adle H, Wechsler J, Garchon HJ, Revuz J, Roujeau JC. Apoptosis as a mechanism of keratinocytedeath in toxic epidermal necrolysis. Br J Dermatol.1996; 134:71 0-4.
Auquier-Dunant A, Mochenhaupt M, Naldi L, Correia O, Schroder W, Roujeau JC. Correlations between clinical patterns and causes of Erythema multiforme majus, Stevens-Johnson Syndrome, and Toxic Epidermal Necrolysis. Arch Dermatol. 2002;138:1019-24.
Revis JR, Don R. Erythema Multiforme (Stevens-JohnsonSyndrome). eMedicine [serial on the Internet]. June 13, 2005 [cited 2005 Sep 24]. [about 13 p.]. Available from: http://www.emedicine.com/MED/topic727.htm
Stevens AM, Johnson FC. A new eruptive fever associated with stomatitis and ophtalmia. Report of two cases in children. Am J Dis Child.1922;24:526-33.
Roujeau JC, Kelly JP, Naldi L, Rzany B, Stern R,Anderson T, et al. Medication use and the risk of Stevens-Johnson syndrome or toxíc epidermal necrolysis. N Engl J Med.1995;333(24):1600-7.
Lin MS, Dai YS, Pwu RF, Chen YH, Chang NC. Risk estimates fer drugs suspected of being associated with Stevens-Johnson syndrome and toxic epidermal necrolysis: a case-control study. Internal Medicine Journal. 2005;35: 188-90.
Garcia-Dovall, LeCleach L, Bocquet H, Otero XL, Roujeau JC. Toxic epidermal necrolysis and Stevens-Johnson syndrome: does early withdrawal of causative drugs decrease the risk of death? Arch Dermatol. 2000;136:323-27.
Monafo WW. Current concepts: initial management of burns. N Engl J Med. 1996;335:1581-6.
Murphy JT, Purdue GF, Hunt JL. Toxic epidermal necrolysis. J Burn CaMcGee T, MunsterA. Toxic epidermal necrolysis syndrome: mortality rate reduced with early referral to regional burn center. Plast Reconstr Surg. 1998;102: 1018-22.
re Rehabil. 1997;18:417-20.
Peng YZ, Yuan ZO, Xiao, GX. Effects of early enteral feeding on the prevention of enterogenic infection in severely burned patients. Burns. 2001 ;27:145-9
Demling RH, Orgill DP. The anticatabolic and wound healing effects of the testosterone analog oxandrolone after severe bum injury. J Crit Careo 2000;15:12-7.
Demling RH. Comparison of the anabolic effects and complications of human growth hormone and the testosterone analog, oxandrolone, after severe burn injury. Burns. 1999;25:215-21.
Coudray-Lucas C, Le Bever H, Cynober L, De Bandt JP, Carsin H. Ornithine alphaketoglutarate improves wound healing in severe bum patients: a prospective randomizeddouble-blind trial versus isonitrogenous controls. Crit Care Med. 2000;28: 1772-6.
Tanaka H, Matsuda T, Miyagantani Y, Yukioka T, Matsuda H, Shimazaki S. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study. Arch Surg. 2000; 135:326-33.
Romero-Rangel T, Stavrou P, Cotter J, Rosenthal P, Baltatzis S, Foster CS. Gaspermeable scleral contact lens therapy in ocular surface disease. Am J Ophthalmol. 2000; 130:25-32.
Engelhardt SL, Schurr MJ, Helgerson RB. Toxic epidermal necrolysis: an analysis of referral patterns and steroid usage. J Burn Care Rehabil. 1997;18:520-4.
Schulz JT, Sheridan RL, Ryan CM, MacKool B, Tompkins RG. A 10-year experience with toxic epidermal necrolysis. J Burn Care Rehabil. 2000;21 :199-204.
Kelemen JJ, Cioffii WG, McManus WF, MasonADJ, Pruitt BAJ. Bum center care for patients with toxic epidermal necrolysis. J Am ColI Surg. 1995;180:273-8.
Viard 1, Wehrli P, Bullani R, Schneider P, Holler N, Salomon D, et al. Inhibition oftoxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. Science. 1998;282:490-3.
Furubacke A, Berlin G, Anderson C, Sjoberg F. Lack of significant treatment effect of plasma exchange in the treatment of drug-induced toxic epidermal necrolysis? Intensive Care Med. 1999;25:1307-10.
Frangogiannis NC, Boridy 1, Mazhar M, Mathews R, Gangopadhyay S, Cate T. Cyclophosphamide in the treatment of toxic epidermal necrolysis. South Med J. 1996;89:10013.
Bastuji-Garin S, Fouchard N, Bertocchi M, Roujeau JC, Revuz J, Wolkenstein P. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol. 2000;115:149-53.by, D.W., Lazar, T. Erythema multiforme exudativum major (Stevens-Johnson syndrome). Lance!. 1951; i: 1091-5.

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[1] Berger T Skin, Hair, & Nails. In: Tierney L, McPhee S, Papadakis M, editors. Current Medical Diagnosis & Treatment. USA: McGraw-Hill/Appleton & Lange; 2005. p.105.

[2] World Health Organization. WHO Drug Information. WHO Drug Information. [serial on the internet] 2004 [cited 2005 Sep 23] Vol 18, No. 3.[about 2 p.] Available from: http:// whqlibdoc.who.inUdruginfo/18_3_2004.pdf

[3] Estadistica de Reacción adversas medicamentosas según Año, CNFV, 1998-2005. Ministerio de Salud. República de Panamá.

[4] Paul C, Wolkenstein P, Adle H, Wechsler J, Garchon HJ, Revuz J, Roujeau JC. Apoptosis as a mechanism of keratinocytedeath in toxic epidermal necrolysis. Br J Dermatol.1996; 134:71 0-4.

[5] Auquier-Dunant A, Mochenhaupt M, Naldi L, Correia O, Schroder W, Roujeau JC. Correlations between clinical patterns and causes of Erythema multiforme majus, Stevens-Johnson Syndrome, and Toxic Epidermal Necrolysis. Arch Dermatol. 2002;138:1019-24.

[6] Revis JR, Don R. Erythema Multiforme (Stevens-JohnsonSyndrome). eMedicine [serial on the Internet]. June 13, 2005 [cited 2005 Sep 24]. [about 13 p.]. Available from: http://www.emedicine.com/MED/topic727.htm

[7] Stevens AM, Johnson FC. A new eruptive fever associated with stomatitis and ophtalmia. Report of two cases in children. Am J Dis Child.1922;24:526-33.

[8] Roujeau JC, Kelly JP, Naldi L, Rzany B, Stern R,Anderson T, et al. Medication use and the risk of Stevens-Johnson syndrome or toxíc epidermal necrolysis. N Engl J Med.1995;333(24):1600-7.

[9] Lin MS, Dai YS, Pwu RF, Chen YH, Chang NC. Risk estimates fer drugs suspected of being associated with Stevens-Johnson syndrome and toxic epidermal necrolysis: a case-control study. Internal Medicine Journal. 2005;35: 188-90.

[10] Garcia-Dovall, LeCleach L, Bocquet H, Otero XL, Roujeau JC. Toxic epidermal necrolysis and Stevens-Johnson syndrome: does early withdrawal of causative drugs decrease the risk of death? Arch Dermatol. 2000;136:323-27.

[11] Monafo WW. Current concepts: initial management of burns. N Engl J Med. 1996;335:1581-6.

[12] Murphy JT, Purdue GF, Hunt JL. Toxic epidermal necrolysis. J Burn CaMcGee T, MunsterA. Toxic epidermal necrolysis syndrome: mortality rate reduced with early referral to regional burn center. Plast Reconstr Surg. 1998;102: 1018-22.

[13] re Rehabil. 1997;18:417-20.

[14] Peng YZ, Yuan ZO, Xiao, GX. Effects of early enteral feeding on the prevention of enterogenic infection in severely burned patients. Burns. 2001 ;27:145-9

[15] Demling RH, Orgill DP. The anticatabolic and wound healing effects of the testosterone analog oxandrolone after severe bum injury. J Crit Careo 2000;15:12-7.

[16] Demling RH. Comparison of the anabolic effects and complications of human growth hormone and the testosterone analog, oxandrolone, after severe burn injury. Burns. 1999;25:215-21.

[17] Coudray-Lucas C, Le Bever H, Cynober L, De Bandt JP, Carsin H. Ornithine alphaketoglutarate improves wound healing in severe bum patients: a prospective randomizeddouble-blind trial versus isonitrogenous controls. Crit Care Med. 2000;28: 1772-6.

[18] Tanaka H, Matsuda T, Miyagantani Y, Yukioka T, Matsuda H, Shimazaki S. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study. Arch Surg. 2000; 135:326-33.

[19] Romero-Rangel T, Stavrou P, Cotter J, Rosenthal P, Baltatzis S, Foster CS. Gaspermeable scleral contact lens therapy in ocular surface disease. Am J Ophthalmol. 2000; 130:25-32.

[20] Engelhardt SL, Schurr MJ, Helgerson RB. Toxic epidermal necrolysis: an analysis of referral patterns and steroid usage. J Burn Care Rehabil. 1997;18:520-4.

[21] Schulz JT, Sheridan RL, Ryan CM, MacKool B, Tompkins RG. A 10-year experience with toxic epidermal necrolysis. J Burn Care Rehabil. 2000;21 :199-204.

[22] Kelemen JJ, Cioffii WG, McManus WF, MasonADJ, Pruitt BAJ. Bum center care for patients with toxic epidermal necrolysis. J Am ColI Surg. 1995;180:273-8.

[23] Viard 1, Wehrli P, Bullani R, Schneider P, Holler N, Salomon D, et al. Inhibition oftoxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. Science. 1998;282:490-3.

[24] Furubacke A, Berlin G, Anderson C, Sjoberg F. Lack of significant treatment effect of plasma exchange in the treatment of drug-induced toxic epidermal necrolysis? Intensive Care Med. 1999;25:1307-10.

[25] Frangogiannis NC, Boridy 1, Mazhar M, Mathews R, Gangopadhyay S, Cate T. Cyclophosphamide in the treatment of toxic epidermal necrolysis. South Med J. 1996;89:10013.

[26] Bastuji-Garin S, Fouchard N, Bertocchi M, Roujeau JC, Revuz J, Wolkenstein P. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol. 2000;115:149-53.by, D.W., Lazar, T. Erythema multiforme exudativum major (Stevens-Johnson syndrome). Lance!. 1951; i: 1091-5.

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