Ethosuximide-induced Stevens–Johnson syndrome: Beneficial effect of early intervention with high-dose corticosteroid therapy

Kota Tachibana, Toshihisa Hamada, Hiroki Tsuchiya, Takashi Shibata, Kazuyasu Fujii, Katsuhiro Kobayashi, Keiji Iwatsuki

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

We report two rare cases of childhood epilepsy patients who developed ethosuximide-induced Stevens–Johnson syndrome (SJS). Unlike typical SJS, the initial eruption of both patients presented well-demarcated, infiltrating firm papules mainly on the cheeks and the extensor aspects of the arms (case 1), and multiple vesicles on the soles and oral aphthosis (case 2), which closely mimicked viral exanthema. We diagnosed both patients with ethosuximide-induced SJS, based on the dosing period and the positive results of drug-induced lymphocyte stimulation test. Systemic corticosteroids are usually selected as a standard therapy for SJS, despite controversial results regarding their effectiveness. In case 1, an i.v. pulse therapy of methylprednisolone (30 mg/kg, 3 days consecutively) was initiated on day 7 from the onset of illness, and an i.v. immunoglobulin (400 mg/kg, 5 days consecutively) was added the following day. In case 2, an i.v. prednisone treatment (1 mg/kg, for 1 week) was initiated on day 4 from the onset. Eventually, the early therapeutic interventions resulted in good outcomes in both patients.

Original languageEnglish
Pages (from-to)592-595
Number of pages4
JournalJournal of Dermatology
Volume45
Issue number5
DOIs
Publication statusPublished - May 2018

Keywords

  • Stevens–Johnson syndrome
  • anticonvulsant
  • corticosteroid
  • ethosuximide
  • i.v. immunoglobulin

ASJC Scopus subject areas

  • Dermatology

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