Allergy Asthma Respir Dis.  2015 Nov;3(6):446-448. 10.4168/aard.2015.3.6.446.

Pravastatin-induced Stevens-Johnson syndrome

• Yu JE
• Choi YH
• Jeong J
• Cho KM
• Koh YI

• KMID: 2218634
• DOI: http://doi.org/10.4168/aard.2015.3.6.446

Abstract

Stevens-Johnson syndrome (SJS) manifests with severe cutaneous reactions, most commonly triggered by medications, which are characterized by fever and mucocutaneous lesions leading to necrosis and sloughing of the epidermis. To our knowledge, pravastatin-induced SJS has not yet been reported. Here, we describe a case of SJS due to pravastatin, which was diagnosed by a patch test. A 70-year-old woman presented with maculopapular skin rashes, which developed 2 weeks after medication of bisoprolol, amlodipine, pravastatin, spironolactone, and indobufene for cardiac problems. Various bullous-erosive mucocutaneous lesions occupied less than 10% of the total body surface area. Painful oropharyngeal mucous membrane lesions were observed. The vermilion border of the lips became denuded and developed serosanguinous crusts. With the drug withdrawal and the use of systemic corticosteroids, her manifestations resolved. Drug patch tests with bisoprolol, amlodipine, pravastatin, spironolactone, and indobufene were performed, resulting in a positive reaction to pravastatin, but not to the other drugs. To the best of our knowledge, this is the first case of pravastatin-induced SJS.

Keyword

Stevens-Johnson syndrome; Pravastatin; Patch test

MeSH Terms

Adrenal Cortex Hormones
Aged
Amlodipine
Bisoprolol
Body Surface Area
Epidermis
Exanthema
Female
Fever
Humans
Lip
Mucous Membrane
Necrosis
Patch Tests
Pravastatin
Spironolactone
Stevens-Johnson Syndrome*
Adrenal Cortex Hormones
Amlodipine
Bisoprolol
Pravastatin
Spironolactone

Figure

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  Fig. 1 Vermilion border of the lips became denuded and developed crusts.

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  Fig. 2 Results of patch tests with spironolactone (1), bisoprolol (2), indobufene (3), amlodipine (4), and pravastatin (5) at the concentration of 1:100, 1:10, and 1:1 dilutions. 1:1 dilution denotes 25 mg/mL for spironolactone, 2.5 mg/mL for bisoprolol, 200 mg/mL for indobufene, 10 mg/mL for amlodipine, and 5 mg/mL for pravastatin.

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