Corona virus disease 2019-associated Stevens-Johnson syndrome: a case report

Shahraki, Toktam; Hassanpour, Kiana; Arabi, Amir; Ansari, Iman; Sadoughi, Mohammad Mehdi

doi:10.1186/s12886-021-02033-y

Cited by 11 publications

(9 citation statements)

References 5 publications

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“…18 Also, there are studies in which primarily coronavirus infection is mainly held responsible for the etiology of SJS/TEN. 12,19,20 In addition, SJS/TEN was detected in two cases with acute respiratory distress syndrome compatible with COVID-19 despite a negative COVID-19 PCR test. 21 Like in the classical SJS/TEN, various opinions about immunosuppressive treatments are present in COVID-19 related SJS/TEN cases, due to its effect on coronavirus infection.…”

Section: Discussionmentioning

confidence: 97%

“…In the past studies, there are SJS/TEN case reports related to COVID‐19 vaccination 10,17 and drugs for COVID‐19 treatment 18 . Also, there are studies in which primarily coronavirus infection is mainly held responsible for the etiology of SJS/TEN 12,19,20 . In addition, SJS/TEN was detected in two cases with acute respiratory distress syndrome compatible with COVID‐19 despite a negative COVID‐19 PCR test 21 .…”

Section: Discussionmentioning

confidence: 99%

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The role of treatment with plasma exchange therapy in two pediatric toxic epidermal necrolysis cases related to COVID‐19

Varol

Can

Şahin

et al. 2022

J of Clinical Apheresis

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Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life‐threatening mucocutaneous reactions characterized by necrosis and detachment of the epidermis. Drugs and bacterial or viral infections are the most common causes of SJS/TEN. Although cases of SJS/TEN have been reported after hydroxychloroquine, vaccine (mRNA [Biontech], and inactivated vaccine [Sinovac]) administration and during the clinical course of active Coronavirus disease 2019 (COVID‐19), limited data is indicating the COVID‐19 disease as a triggering factor. Also, there are no pediatric cases of SJS/TEN associated with COVID‐19 in the literature. Herein we reported two pediatric cases with a diagnosis of TEN related to COVID‐19. Therapeutic plasma exchange therapy was applied to both of our patients. Although there are a few adult cases in the literature, our article is the first pediatric case report about patients diagnosed with TEN related to COVID‐19 and successfully treated with plasma exchange.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

The role of treatment with plasma exchange therapy in two pediatric toxic epidermal necrolysis cases related to COVID‐19

Varol

Can

Şahin

et al. 2022

J of Clinical Apheresis

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“…In conclusion, skin reactions related to SARS-CoV-2 infection have been commonly reported since the beginning of the COVID-19 pandemic in 2020 but only few cases were observed with acute severe skin reactions like FS. 9,10 This case emphasizes the need for careful workup of acute skin and mucosal lesions following SARS-CoV-2 infection even in the absence of COVID signs and symptoms.…”

Section: E1090 |mentioning

confidence: 89%

SARS‐CoV‐2 infection associated with severe oral, conjunctival and genital lesions (Fuchs syndrome)

Ganjuur

D’Urso

Girbig

et al. 2023

Acad Dermatol Venereol

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Dear Editor, With the onset of the COVID-19 pandemic and the emergence of COVID-19 vaccinations, numerous cases of skin reactions related to SARS-CoV-2 infection and to vaccination have been reported, including urticaria, chilblain lesions and morbilliform rashes. 1,2 Furthermore, the induction or worsening of inflammatory skin diseases was observed. 3 However, reports on severe skin reactions like erythema exsudativum multiforme (EEM), Stevens-Johnson syndrome (SJS) and Fuchs syndrome (FS) related to SARS-CoV-2 infection are scarce. We here present a case of FS after SARS-CoV-2 infection.A 34-year-old Caucasian woman presented to our dermatological outpatient clinic with severe acute fatigue, fever, malaise, swelling of cervical lymph nodes and sudden development of infiltrating lesions on mucous membranes. Four days before, blisters and ulcers developed in the oral mucosa, the lips and the genital mucosae with concomitant conjunctivitis. No other skin lesions were observed. Initial treatment with acyclovir 5 × 800 mg by her general practitioner showed no improvement. The patient reported no other medical history, but an asymptomatic SARS-CoV-2 infection verified by an antigen test 2 weeks before first symptoms. Clinical examination revealed haemorrhagic erosions with crusting on the lips and eroded lingual lesions (Figure 1). Marked conjunctival infiltration was observed in both eyes (Figure 2). This symptom complex was clinically diagnosed as FS. To rule out differential diagnoses, extensive blood analyses were performed, and mucosal swabs taken, excluding herpes simplex virus (HSV) infection by polymerase chain reactions. Elevated C-reactive protein to 84 mg/L (reference: <5 mg/L) and thrombocytosis were observed (493 bn/L [150-370 bn/L]); liver and renal function test, white and red blood count, electrolytes and anti-streptolysin titre revealed normal results.The patient had been vaccinated against COVID three times, the last being applied 18 weeks before the onset of acute mucosal lesions. We thus concluded that this episode of FS was most likely triggered by SARS-CoV-2 infection. Due to malaise, fever, fatigue and severely worsening general condition, the patient was admitted to a dermatology hospital. Treatment included systemic prednisolone (100 mg/daily for 3 days), topical antiseptics and anaesthetic mouthwash. After ophthalmological review, prednisolone eye drops were applied for conjunctival involvement. The patient fully recovered within a week without any clinical sequelae.Clinical diagnosis of acute severe SJS-like mucosal lesions in the absence of extramucosal lesions has been described as FS. Currently, there is no published consensus on the specific criteria of FS. It is considered a rare clinical variant of erythema multiforme majus (EEM). 4 Although

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“…Literature review projects some adult cases with SJS associated with COVID-19 21 , 22 ; however, according to reports, the disease seems to be rare in children 16 . Shahraki et al .…”

Section: Discussionmentioning

confidence: 99%

Stevens–Johnson syndrome and COVID-19: a case report with suspected multisystem inflammatory syndrome in children (MIS-C)

Ebrahimi,

Aghapour,

Rashidbaghan

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: The symptoms similar to diseases such as Stevens-Johnson syndrome (SJS) and multi systemic inflammatory syndrome in children (MIS-C) were reported in pediatric coronavirus infections. Case presentation: Here, we present a 4-year-old girl with COVID-19 and earlier diagnosis of SJS and final diagnosis of MIS-C. Clinical discussion: Unlike the negative PCR test for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the positive serological test confirmed COVID-19. Conclusion: The monitoring of this case indicated that higher coronavirus infection can delay in immune reaction and causes symptoms similar to SJS.

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Corona virus disease 2019-associated Stevens-Johnson syndrome: a case report

Cited by 11 publications

References 5 publications

The role of treatment with plasma exchange therapy in two pediatric toxic epidermal necrolysis cases related to COVID‐19

The role of treatment with plasma exchange therapy in two pediatric toxic epidermal necrolysis cases related to COVID‐19

SARS‐CoV‐2 infection associated with severe oral, conjunctival and genital lesions (Fuchs syndrome)

Stevens–Johnson syndrome and COVID-19: a case report with suspected multisystem inflammatory syndrome in children (MIS-C)

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