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Research Journal of Pharmacy and Technology
Year : 2019, Volume : 12, Issue : 8
First page : ( 3735) Last page : ( 3738)
Print ISSN : 0974-3618. Online ISSN : 0974-360X.
Article DOI : 10.5958/0974-360X.2019.00639.5

Case report on Fluconazole Induced stevens -Johnson Syndrome

Antony Remya1, Fernandez Ashly1, Lekshmi Sandhya1, Velayudhan Sreedevan2, Jose Sruthy1, Vijayan Meenu1,*

1Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, 682041, Kerala, India

2Department of Dermatology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, 682041, Kerala, India

*Corresponding Author E-mail: meenuvijayan@aims.amrita.edu

Online published on 24 December, 2019.

Abstract

Stevens-Johnson syndrome (SJS) is a rare cutaneous reaction characterised by mucosal erosions and epidermal detachment of about less than 10% of the total area of body skin. The incidence of SJS is approximately 1–6 cases per million person-years. The incidence of fluconazole induced SJS is less than 1%. Here the patient came with complaints of scaly lesions over chest and axilla following which he was started on topical antifungals (Lulliconazole) and antihistamines with the suspicion of Tinea versicolor. Though few lesions resolved on treatment, the patient later developed a small scaly macule over the left upper arm. Thus the patient upon further evaluation was given a stat dose of Tablet Fluconazole 400mg. Following this, the patient developed swelling of lower lips and tip of the glans and erythema over palms. This was later confirmed as Stevens-Johnson syndrome. The reaction was suspected to have occurred in association with Fluconazole. Fluconazole had a probable causal relationship with Stevens Johnson Syndrome as per ALDEN Algorithm in the EuroSCAR study. As per the Naranjo ADR probability scale, the causality assessment score for this reaction was found to be 5 which indicates a probable causal relationship. Clinicians must be more vigilant while prescribing Fluconazole by conducting regular monitoring of such patients and carrying out early diagnosis of such reactions.

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Keywords

Stevens Johnson Syndrome, fluconazole, toxic epidermal necrolysis, ALDEN Algorithm, Naranjo ADR probability scale.

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