Tenofovir disoproxil fumarate
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Stevens-Johnson syndrome: case report A 61-year-old woman developed Stevens-Johnson syndrome (SJS) during treatment with tenofovir disoproxil fumarate for acute hepatitis-B. The woman had a history of diabetes mellitus and hypertension. She presented to an outpatient department (OPD) with easy fatigability during the previous week, mild abdominal pain and jaundice. Following investigations, she was diagnosed with acute hepatitis-B (day 1). She presented 14 days later at the OPD with complaints of tiredness and mild pruritus. Owing to severe acute hepatitis with deepening jaundice and deranged INR, she was prescribed with oral tenofovir disoproxil fumarate 300mg once daily. Concomitantly, she was receiving various other drugs. Five days later (on day 20), she presented at the emergency department with difficulty swallowing, a burning sensation all over the body along with erythematous polymorphic rash present over the face, upper limbs, and trunk. During admission, she was conscious, oriented with normal vitals and had an elevated oral temperature, along with deranged liver function test findings and INR. An adverse reaction to tenofovir disoproxil fumarate was suspected due to the sudden appearance of lesions. Tenofovir disoproxil fumarate was withdrawn. Over the subsequent 2 days, the woman gradually developed erythematous maculopapular rashes all over the body, which started over the upper back and gradually involved the chest, abdomen and upper and lower limbs, with ulceration in the mouth followed by blistering of the lips. She also developed foreign body sensation and redness in both eyes, along with dimness of vision, conjunctivitis and mucopurulent discharge. An epidermal detachment was noted in
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