Journal article
Iatrogenically induced Stevens-Johnson syndrome after a car accident
Optometry (Saint Louis, Mo.), v 82(1), pp 9-14
01 Jan 2011
PMID: 20947438
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: Stevens-Johnson syndrome (SJS) is a hypersensitivity reaction that targets the skin and mucosal membranes. Ophthalmic manifestations may include conjunctival and corneal keratinization, shortening of the fornices, symblepharon, entropion, trichiasis, and adnexal cutaneous blisters. The syndrome is often misdiagnosed, and patients are treated incompletely with topical agents only leading to a worsening of the condition and graduated symptoms.
CASE: A 61-year-old black man was admitted to the hospital for management and rehabilitation of multiple lower limb fractures after an automobile accident. The ophthalmic service was consulted regarding a persistent bilateral conjunctivitis that was worsening and recalcitrant to standard topical antimicrobial therapies. Best-corrected visual acuities were 20/70 in the right eye (O.D.) and the left eye (O.S.) secondary to grade Ill punctate corneal epitheliopathy resulting from evolving cicatricial ectropion. Anterior segment examination uncovered maderosis, blepharoconjunctivitis and dense corneal subepithelial infiltration from 3 to 5 o'clock. Externally there was bilateral juxtaorbital and transfacial skin blistering. After a review of history, the diagnosis of SJS was made, presumably secondary to recent oral antibiotic administration. Topical and oral steroids were initiated while concurrently seeking a dermatologic consult. The dermatologist agreed with our findings and management. The disease responded to the oral and topical regimen with significant reduction of signs and symptoms. An immediate physical improvement was evident within 10 days.
CONCLUSIONS: Stevens-Johnson syndrome is a multifactorial hypersensitivity reaction requiring prompt systemic and local anti-inflammatory therapy.
Optometry 2011;82:9-14
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Details
- Title
- Iatrogenically induced Stevens-Johnson syndrome after a car accident
- Creators
- Julie K. Hutchinson - Drexel University Elkins Park CampusAndrew S. Gurwood - Drexel University Elkins Park Campus
- Publication Details
- Optometry (Saint Louis, Mo.), v 82(1), pp 9-14
- Publisher
- Elsevier
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pennsylvania College of Optometry (PCO)
- Web of Science ID
- WOS:000291708400004
- Scopus ID
- 2-s2.0-78649922999
- Other Identifier
- 991022019496204721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Ophthalmology