Acyclovir Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis - A Rare Case Report

Abstract

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis are serious, life-threatening conditions often triggered by drug reactions, characterized by widespread skin detachment and mucosal involvement. This case report describes a 29-year-old woman who developed Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis after receiving prophylactic acyclovir for suspected herpes. The patient initially presented with oral ulcers that rapidly progressed to widespread blisters, ulcers, and severe skin peeling. A thorough diagnostic evaluation, including skin biopsy and the Naranjo algorithm, identified acyclovir as the causative agent. The patient was managed in intensive care with intravenous methylprednisolone 500mg per day for 3 consecutive days as pulse therapy, antibiotics, and other supportive treatments. This case underscores the importance of early recognition, prompt discontinuation of the offending drug, and a multidisciplinary treatment approach. It also highlights the critical need for heightened awareness among healthcare professionals regarding the potential for severe adverse reactions with commonly used medications like acyclovir, to improve patient safety and outcomes.