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• W4200336156 abstract "Rationale: Stevens-Johnson syndrome (SJS) is a cutaneous reaction characterized by necrosis and epidermal detachment, commonly triggered by medications. Tramadol rarely causes SJS, and ultraviolet radiation (UVR) has limited recognition as being linked to SJS presentations. Patient concerns: A previously healthy 18-year-old female presented to the emergency department with what she believed to be a severe sunburn. Five days prior, she was exposed to extensive sun exposure while swimming all day at a lake. The following day, she developed a rash on her shoulders, which became widespread, extending to the palms of her hands and soles of her feet, and eventually involved her oral and ocular mucosa. At the time of hospital admission, the rash had progressed to form vesicles/bullae with skin sloughing and a positive Nikolsky sign, bleeding ulcers throughout the oral mucosa, and bilateral conjunctival hyperemia with purulent discharge. Diagnosis: The patient reported no medication use apart from a single dose of tramadol 7 to 10 days prior to rash onset. Given the clinical presentation and histopathological findings that were consistent with SJS, a diagnosis of SJS was made. The nature of this patient's rash onset, character, and progression suggests that UVR precipitated the event in conjunction with tramadol as the causative agent. Interventions: The patient received fluid resuscitation and was transferred via air ambulance to a trauma and burn center to receive treatment. Outcomes: Complete resolution of the patient's cutaneous and oral mucosal lesions occurred 4 weeks after discharge; however, hypopigmentation was evident in areas where cutaneous re-epithelialization had occurred. The patient was advised to strictly avoid the use of tramadol and limit her exposure to UVR. Lesson: Physicians should be aware that tramadol may cause SJS and that UVR may precipitate SJS in patients taking tramadol. Rapid diagnosis of SJS and transfer to a trauma or burn center improves patient outcomes." @default.
• W4200336156 created "2021-12-31" @default.
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• W4200336156 date "2021-12-01" @default.
• W4200336156 modified "2023-09-26" @default.
• W4200336156 title "Stevens-Johnson syndrome linked to tramadol use and ultraviolet radiation" @default.
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• W4200336156 doi "https://doi.org/10.1097/md9.0000000000000176" @default.
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