Stevens-Johnson Syndrome: Case Report and Literature Review

Stevens-Johnson Syndrome is an acute and potentially life-threatening mucocutaneous disease characterized by extensive epidermal necrosis and severe mucosal involvement, usually associated with drug-induced hypersensitivity reactions. We present the case of a 9-year-old female patient with a recent history of treatment with trimethoprim/sulfamethoxazole for a respiratory infection, who initially developed fever, malaise, odynophagia, and bilateral conjunctivitis, subsequently progressing to painful erythematous bullous lesions with epidermal detachment and oral and ocular involvement. Physical examination revealed extensive skin lesions on the dorsal region and upper extremities with a positive Nikolsky sign, involving approximately 12% of the total body surface area. Laboratory studies showed leukocytosis and elevated acute phase reactants. Due to the clinical suspicion of Stevens-Johnson syndrome secondary to a drug reaction, the antibiotic was immediately discontinued and intensive multidisciplinary management was initiated, including fluid replacement, analgesia, advanced wound care, systemic corticosteroids, and intravenous immunoglobulin therapy. In addition, a skin biopsy and histopathological study were performed, reporting full-thickness epidermal necrosis and basal vacuolar degeneration, findings compatible with Stevens-Johnson syndrome. Clinical evolution was favorable, with progressive reepithelialization and improvement of skin lesions without severe systemic complications. This case highlights the importance of early recognition, immediate withdrawal of the causative agent, and timely multidisciplinary management in order to reduce morbidity and mortality and prevent sequelae associated with this highly complex dermatological entity.