Carbamazepine Induced Stevens-Johnson Syndrome and Toxic Epidermal
Necrolysis: A Clinical Case Report of a Rare Adverse Drug Reaction
Abstract
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are
rare but life-threatening skin reactions, often triggered by medications
such as antiepileptic drugs, nonsteroidal anti-inflammatory drugs, and
certain antibiotics. Carbamazepine is one of the most common
antiepileptic medicine that causes SJS. A 13-year-old male with a
history of 2 years of epilepsy presented with a painful rash and
extensive blistering with mucous membrane involvement, along with fever
and Nilkolsky sign. Based on clinical presentation and previous
medication history, the patient was diagnosed with Stevens-Johnson
syndrome, and carbamazepine was identified as the cause. Carbamazepine
was discontinued, and the patient was given nutritional support, wound
care, and intravenous fluids, along with steroid and antihistamine
treatment. The patient’s symptoms improved, and he was discharged after
13 days. Physicians must be aware of the potential for life-threatening
drug hypersensitivity reactions in patients taking certain medications,
particularly antiepileptic drugs. A thorough history and careful
monitoring are essential for the early recognition and treatment of SJS
and TEN. We want to advise all physicians that for patients with a
previous drug reaction to this class of medication, carbamazepine
prescribing should be avoided.
KEYWORDS: Stevens-Johnson syndrome (SJS),
toxic epidermal necrolysis (TEN), carbamazepine (CBZ), phenytoin (PHT),
ADR.