Stevens-Johnson syndrome (SJS) is a rare but potentially fatal disease of the skin and mucous membranes, most often triggered by medication use. According to statistics, the mortality rate for this syndrome ranges from 5 to 12%.
Between August and September 2025, two cases of Stevens-Johnson syndrome provoked 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 involving the skin and mucous membranes of at least two organs, making it a severe form of erythema multiforme.
According to the study, the main factor contributing to the development of the syndrome is drug allergy, with the highest risk associated with the use of antibiotics, non-steroidal anti-inflammatory drugs, antiepileptic medications, barbiturates, local anesthetics, and vaccines. Typically, the disease manifests itself within the first four weeks of treatment, and in half of the cases, the specific cause remains unknown.
During the study, patients underwent treatment for ten days, during which doctors monitored the dynamics of clinical manifestations and documented the course of the disease with detailed photographic reports.
Clinical example: On August 25, 2025, a man named A. M. K., born in 1963, was hospitalized in the dermatology department of RCDV. Upon admission, he complained of rashes on the skin of the upper and lower extremities, painful sensations in the oral cavity when eating and swallowing, a rare cough with difficult-to-expectorate sputum, general weakness, and headaches.
According to disease information: symptoms appeared four days ago and are associated with the intake of carbamazepine while in the narcology department. The patient exhibited swelling of the lips, hands, and feet, as well as a scratchy throat. Despite the treatment he received from the ambulance, the symptoms did not improve. The skin manifestations continued to worsen, with blisters appearing against a background of swelling and hyperemia. Eventually, he sought help at RCDV and was hospitalized.
In the medical history: the patient consumed alcohol during holidays and experienced a binge in August 2025 for a week due to psycho-emotional stress, during which he was hospitalized in narcology. In the allergy history, he had allergic dermatitis after an infusion of ascorbic acid.
The clinical picture showed acute, extensive lesions of the mucous membranes of the oral cavity, lips, and distal parts of the extremities. Multiple blisters (bullae) with serous contents were observed on a hyperemic and edematous background on the arms and legs, and at the sites of their resolution - superficial erosions with a shiny surface and fragments of the epidermis. The Nikolsky sign was positive. On the lips - hemorrhagic crusts, the oral mucosa was bright red, and superficial erosions covered with purulent crusts were observed on the mucous membranes of both cheeks and the soft palate. The conjunctiva of both eyes was hyperemic. Considering the history and clinical data, the diagnosis was established as "Stevens-Johnson syndrome caused by drug intake."
The patient left the hospital after ten days with improved condition and recommendations.
Experts emphasize that the issue of timely diagnosis and treatment of Stevens-Johnson syndrome remains relevant in Kyrgyzstan, as in other countries. Assessing the actual prevalence of the disease in the country is challenging due to a lack of statistical data. It should also be noted that advanced age and the presence of comorbidities significantly increase the risk of fatal outcomes.
The conclusion of the study highlights that medical professionals are advised to avoid re-prescribing carbamazepine to patients who have previously experienced Stevens-Johnson syndrome or other serious skin reactions to this medication.
The image on the main page is for illustrative purposes: stimul-clinic.ru.
