Management of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: A Case Report and Literature Review

J Drugs Dermatol. 2023 Nov 1;22(11):e24-e28. doi: 10.36849/JDD.6999.

Abstract

Introduction: Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a rare and dangerous dermatologic emergency. It can have different presentations, especially in patients with multiple drug causes, and definitive management of SJS/TEN in these presentations remains unclear. Systemic corticosteroids, TNF inhibitors, and cyclosporine A are promising therapies.

Case report: In this case report, we present a 55-year-old man who developed SJS/TEN while on pembrolizumab and lamotrigine. The patient was treated with corticosteroids and a single dose of etanercept. After a one-week follow-up, the patient’s SJS/TEN had no new activity.

Discussion: This literature review highlights how SJS/TEN may present differently in patients on immune checkpoint inhibitors. Treatments in these cases may vary from those with classic SJS/TEN.  Specifically, etanercept given days late into the disease course is effective in speeding re-epithelialization and tapering of already given corticosteroids in classic SJS/TEN. J Drugs Dermatol. 2023;22(11):e24-e28     doi:10.36849/JDD.6999e.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones
  • Cyclosporine
  • Disease Progression
  • Etanercept / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Stevens-Johnson Syndrome* / diagnosis
  • Stevens-Johnson Syndrome* / drug therapy
  • Stevens-Johnson Syndrome* / etiology

Substances

  • Etanercept
  • Cyclosporine
  • Adrenal Cortex Hormones