Esophageal Involvement in Stevens-Johnson Syndrome

Abstract

The authors describe the endoscopic aspect of esophageal lesions in five children with Stevens-Johnson syndrome. Lesions involve the entire esophagus, with blistering of the epithelium leading to large ulcerations of the mucosae. Esophageal involvement is probably underestimated in Stevens-Johnson syndrome and may worsen dysphagia caused by oral lesions, leading to malnutrition. Enteral nutrition can be helpful to provide feeding, limit weight loss, and support skin healing. No strictures were diagnosed during the follow-up period of these patients.

Mucocutaneous bullous amyloidosis with an unusual mixed protein composition of amyloid deposits

“…Although extension of bullous lesions to involve oral mucosa has previously been noted in two patients with bullous amyloidosis, 10 to our knowledge there has been no prior description of an oesophagopharyngeal disease. Vesicobullous oesophagitis is known to occur in several types of bullous dermatoses, including bullous pemphigoid, mucous membrane pemphigoid, various forms of pemphigus and epidermolysis bullosa, Hailey–Hailey disease, Darier disease, Stevens–Johnson syndrome and graft‐versus‐host disease 11–14 . The oesophagopharyngeal lesions in our patient were associated with dysphagia and were probably the cause of her gastrointestinal bleeding and microcytic anaemia.…”

Long-term complications of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN): the spectrum of chronic problems in patients who survive an episode of SJS/TEN necessitates multidisciplinary follow-up

“…Although involvement of the GI tract is generally rare, oesophageal strictures are the most common chronic GI complication and develop between 2 months and 2 years after the acute episode . Strictures can be treated successfully with endoscopic dilatation.…”

Spectrum of gastrointestinal involvement in Stevens - Johnson syndrome

“…Esophageal involvement in patients with SJS or TEN is not so rare. Esophageal ulcer and chronic esophageal stricture formation have been described in SJS or TEN[16-20]. Small bowel and colonic involvement are distinctly rare.…”

“…Whitish plaques and pseudomembrane formation over the damaged mucosa are the other endoscopic findings in SJS or TEN. Although colonic pseudomembrane has not been reported yet, ulcerations with adherent pseudomembrane have been described in the esophagus and ileum[16,36].…”