Early surgical correction of microstomia following Stevens-Johnson syndrome

Abstract

Stevens-Johnson syndrome (SJS) is a rare disease in which extensive toxic epidermolysis occurs after medication. Skin and mucous membranes are involved in about 90% of SJS cases, and webbing of mouth corners (microstomia) may occur when they are affected. Few reports have been issued on microstomia in SJS, and no consensus has been reached regarding treatment methods, timings, or results. We encountered a case of microstomia following SJS after ofloxacin medication in a 22-year-old woman treated by commissuroplasty using a lozenge-shaped excision. We present an appropriate correction method and surgical timing for microstomia following SJS.

Prevention and treatment of microstomia

“…Microstomia is related to toxic epidermal necrosis and Steven-Johnson syndrome [ 39 , 40 ]. Other rare causes include congenital maxilla-facial syngnathia and synechiae involving the tongue and lip [ 31 , 40 ].…”

“…There are numerous methods for lip reconstruction, and selecting the right one based on the cause, location, and size of the defect is crucial. To date, more than 200 reconstruction techniques involving various donor sites have been introduced, making it essential to choose the most suitable method for each individual case [ 21 , 32 , 40 , 46 , 47 , 60 - 73 ].…”

“…The choice of treatment depends on the extent of tissue involvement, including skin, mucosa, and muscle. In severe cases of microstomia, where surrounding tissue is unavailable, correction may be achieved using distant flaps or free flaps [ 20 , 29 , 40 , 74 - 76 ]. Microstomia resulting from burns can be corrected through various surgical techniques, including triangular excision at the mouth corner, V-Y or Y-V advancement flap, scar revision, and wound closure using either full-thickness or split-thickness skin grafts, or two rhomboid flaps.…”