Stevens-Johnson syndrome (SJS) is an acute and potentially life-threatening disease of the skin and mucous membranes, often occurring as a result of medication use. According to global statistics, the mortality rate for this syndrome ranges from 5 to 12%.
From August to September 2025, two cases of this syndrome caused by carbamazepine were recorded in the dermatology department of the Republican Center for Dermatovenereology (RCDV). Both patients were hospitalized.
Stevens-Johnson syndrome is classified as a severe toxic-allergic disease and represents a delayed-type hypersensitivity reaction. This condition affects at least two organs, making it a severe form of erythema multiforme.
According to the publication, the main cause of the syndrome's occurrence is drug allergy. The greatest danger comes from antibiotics, non-steroidal anti-inflammatory drugs, antiepileptic agents, barbiturates, local anesthetics, and vaccines. Typically, the disease begins to develop within the first four weeks after treatment initiation, and in half of the cases, the cause remains unclear.
During the study, patients received treatment for ten days. Doctors monitored the disease's progression and documented clinical manifestations through photographic reports.
Clinical case: On August 25, 2025, a man named A. M. K., born in 1963, was admitted to the dermatology department of RCDV. Upon admission, he complained of rashes on the skin of the limbs and mucous membranes, as well as experiencing pain while swallowing and eating, a rare cough with difficult-to-expectorate sputum, general weakness, and headache.
According to available data, he had been ill for four days, linking his condition to the use of carbamazepine while in the narcology department. He exhibited swelling of the lips, hands, and feet, as well as a scratchy throat. After calling an ambulance, he was prescribed various medications, but the treatment was ineffective. The skin manifestations worsened, and blisters appeared against a background of swelling and hyperemia. Eventually, he sought help at RCDV and was hospitalized.
From the medical history: the patient consumed alcohol only on holidays; however, in August 2025, he experienced a binge due to psycho-emotional stress, which required inpatient treatment in narcology. In his allergy history, he had recorded allergic dermatitis after the administration of ascorbic acid.
The skin process turned out to be acute and extensive, affecting the mucous membranes of the oral cavity and lips, as well as the distal parts of the limbs. He was diagnosed with multiple bullae containing serous fluid on a hyperemic and edematous background. In areas of resolution, superficial erosions with a shiny surface and fragments of epidermis at the edges formed. A positive Nikolsky sign was also observed. Hemorrhagic crusts were present on the lips, and the mucous membrane of the oral cavity was bright red, with superficial erosions covered by purulent crusts. The conjunctiva of both eyes was hyperemic. Considering the history and clinical data, the doctors diagnosed him with "Stevens-Johnson syndrome induced by drug use."
After ten days of treatment, the patient was discharged with improved condition and recommendations.
Collapse Specialists emphasize that in Kyrgyzstan, as in other countries, there is a significant problem of timely diagnosis and treatment of Stevens-Johnson syndrome. It is challenging to assess the exact prevalence of this disease in the republic due to a lack of statistical data. Furthermore, advanced age and the presence of comorbidities significantly increase the risk of fatal outcomes.
In conclusion, the study highlights the importance of medical professionals avoiding the re-prescription of carbamazepine to patients who have previously experienced Stevens-Johnson syndrome or other serious skin reactions to this medication.
Photo on the main page is illustrative: stimul-clinic.ru.
