Stevens-Johnson syndrome due to Methotrexate: a case report

Abstract

Stevens-Johnson syndrome is a rare mucocutaneous disorder. It constitutes, together with toxic epidermal necrolysis (Lyell), opposite forms of a spectrum of diseases usually resulting from an adverse reaction to drugs. We report the case of a 67-year-old woman from Morocco who developed Stevens-Johnson syndrome after receiving methotrexate. The evolution was marked by death due to hemodynamic complications. Stevens-Johnson syndrome is a serious condition, with mortality in 10-34% of cases. Management consists in identifying and stopping the responsible drug, and maintaining hemodynamic and respiratory stability, care of skin lesions and pain relief. The use of prognostic scores can assist in management of some complicated cases. Methotrexate is a commonly prescribed drug because of its efficacy and cost-effectiveness/ease of administration. Therefore, physicians should be aware of the consequences of its use, with particular attention to patients with chronic renal failure in whom dosages should be adapted to renal function. This drug should not be used in end-stage patients because of its poor tolerance

Received: June 18^th, 2023

Accepted: November 13^th, 2024

https://dx.doi.org/10.4314/aamed.v18i1.14