Asia Pac Allergy.  2014 Jan;4(1):68-72. 10.5415/apallergy.2014.4.1.68.

Rapid onset of Stevens-Johnson syndrome and toxic epidermal necrolysis after ingestion of acetaminophen

• Kim EJ
• Lim H
• Park SY
• Kim S
• Yoon SY
• Bae YJ
• Kwon HS
• Cho YS
• Moon HB
• Kim TB

• KMID: 2397128
• DOI: http://doi.org/10.5415/apallergy.2014.4.1.68

Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, but life-threatening, severe cutaneous adverse reactions most frequently caused by exposure to drugs. Several reports have associated the use of acetaminophen with the risk of SJS or TEN. A typical interval from the beginning of drug therapy to the onset of an adverse reaction is 1-3 weeks. A 43-year-old woman and a 60-year-old man developed skin lesions within 3 days after administration of acetaminophen for a 3-day period. Rapid identification of the symptoms of SJS and TEN caused by ingestion of acetaminophen enabled prompt withdrawal of the culprit drug. After administration of intravenous immunoglobulin G, both patients recovered fully and were discharged. These two cases of rapidly developed SJS/TEN after ingestion of acetaminophen highlight the possibility that these complications can develop within only a few days following ingestion of over-the-counter medications such as acetaminophen.

Keyword

Stevens-Johnson syndrome; Toxic epidermal necrolysis; Drug; Hypersensitivity; Acetaminophen

MeSH Terms

Acetaminophen*
Adult
Drug Therapy
Eating*
Female
Humans
Hypersensitivity
Immunoglobulin G
Middle Aged
Skin
Stevens-Johnson Syndrome*
Acetaminophen
Immunoglobulin G

Figure

• 

  Fig. 1 Bullous mucocutaneous lesions observed on the patient reported in the first case report. Lesions are shown at the initial (A, B) and advanced (C, D) stages.

• 

  Fig. 2 Bullous mucocutaneous lesions observed on the patient reported in the second case report. Lesions are shown at the initial (A) and advanced (B).

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