Doxycycline
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Stevens-Johnson Syndrome: case report A 16-year-old boy developed Stevens-Johnson syndrome during treatment with doxycycline for acne. The boy, who had moderate papulopustular acne, started receiving antibiotic treatment with adapalene, benzoyl peroxide and oral doxycycline 100 mg/day. Ten days after initiation of antibiotic treatment, he developed painful skin lesions on the oral mucosa and hands with a low-grade fever. He was initially suspected to have mouth-hand-foot disease. After 3 days, the skin lesions spread to the entire body and oral involvement worsened. Therefore, he had difficulty in ingestion of liquids and food. He presented to the emergency department. General examination showed that he was normotensive and afebrile. It also revealed marked signs of general compromise. He had whitish pseudomembranes and oedema of the lips which prevented opening of the mouth. Nikolsky sign was positive. Erythematous lesions on the back, extremeties and trunk covered more than 30% of the body surface, with detachment of less than 10% of the skin. Erythema, erosions and oedema were also observed on the mucosa and glans. An ophthalmological examination showed no ocular alterations. The chest radiography and laboratory tests findings were normal. A skin biopsy revealed perivascular lymphocytic infiltrate in the dermis and multiple necrotic keratinocytes in the epidermis. Based on these findings, he was diagnosed with Stevens-Johnson syndrome secondary to doxycycline treatment. The boy’ treatment with doxycycline was discontinued. He was admitted and treated with unspecified corticosteroids, triamcinolone [triamcinolone acetonide] and unspecified serum therapy. Four days after admission, the mucocutaneous lesions had improved and he was able to eat. After 7 days, he was discharged from the hospital and continued receiving corticosteroids treatment with a tapered dose. In subsequent follow-up, he remained asymptomatic. Morgado-Carrasco D, et al. Stevens-Johnson Syndrome Secondary to Doxycycline Treatment in a Teenage Boy. Actas Dermo-Sifiliograficas 111: 615-617, No. 7, Sep 2020. 803506917 Available from: URL: http://doi.org/10.1016/j.adengl.2020.08.002
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Reactions 10 Oct 2020 No. 1825
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