STEVENS-JOHNSON SYNDROME IN PATIENTS WITH HIV: A CHALLENGING TREATMENT

Abstract

Stevens-Johnson Syndrome (SJS) is a severe mucocutaneous drug reaction characterized by epithelial detachment, painful erosions and ulcers on any mucosal body surface, and systemic symptoms. Patients with HIV are susceptible to many complications, including drug reactions. Patients with HIV with SJS present a worse prognosis and treatment challenges. A 46-year-old HIV-positive woman developed SJS after using amoxicillin-clavulanic acid (Clavulin (glaxosmithkline)), dipyrone, and azithromycin. The patient developed mucocutaneous ulcers, epithelial detachment, and ocular involvement. The oral lesions were successful treated with high potency topical corticosteroids, except for a large ulcer on the dorsal surface of the tongue. Debridement, application of hydrogen peroxide, chlorhexidine, and low-level laser therapy were used without success. Just after the administration of 18 intralesional corticosteroid injections, the lesion had complete remission. The patient is still under treatment for the ocular lesion. The aim of this report is to emphasize the challenge of SJS treatment in patients with HIV.