Theophylline and meloxicam-induced Stevens-Johnson syndrome (SJS)

Abstract

Stevens-Johnson syndrome (SJS) is an infrequent, multisystemic, fatal, immune-mediated hypersensitivity reaction. SJS may be due to adverse effects of drug intake often characterized by mucocutaneous rash, bullae, and blisters spread over the skin and mucous membranes, hyperpigmentation, puffiness, erosive lesions on lips and face. The most common cause of drug-induced SJS is antimicrobials, followed by NSAIDs, allopurinol, antipsychotics, and antiepileptic drugs. Two cases of atypical SJS presentation associated with the use of theophylline and meloxicam are reported here. Early identification and appropriate corticosteroid therapy might improve the condition. The reason for publishing these case reports is to raise an alarm among our health care fraternity and common man regarding medication-induced SJS, which may be dreadful especially due to theophylline used in bronchial asthma and meloxicam used for osteoarthritis and thereby preventing the expected serious sequelae in SJS.