Valproic acid induced Stevens–Johnson syndrome

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Abstract

A 27-year-old transgender female at the stage of gender transition with bipolar disorder for which she received valproic acid developed multiple petechial rashes on the chest, upper and lower extremities, local erythematous lesions with forming blisters, large-platelet peeling on the face, neck, chest and inguinal area, erosion on the oral mucosa. She was diagnosed with drug eruption, Stevens–Johnson syndrome. The diagnosis was verified on the basis of complaints, medical history, clinical picture, laboratory findings. Treatment included valproic acid withdrawal, dexamethasone, infusion therapy, vancomycin, cyclosporine A. Against the background of the therapy, skin condition was improved: there was the epithelization of ulcerative defects and the absence of new elements.

About the authors

Dmitry V. Somov

Pirogov Russian National Research Medical University

Author for correspondence.
Email: somovmd@yandex.ru
ORCID iD: 0000-0002-8874-3663
SPIN-code: 5096-6710

Assistant Lecturer

Russian Federation, Moscow

Alina Yu. Chernyaeva

Pirogov Russian National Research Medical University

Email: alinaache23@gmail.com
ORCID iD: 0000-0002-7142-2484
Russian Federation, Moscow

Veronika A. Mazus

N.I. Pirogov City Clinical Hospital No. 1

Email: veroni2001@list.ru
ORCID iD: 0000-0002-3754-5333
Russian Federation, Moscow

Lyaman T. Nurieva

N.I. Pirogov City Clinical Hospital No. 1

Email: lemi_enigma@mail.ru
ORCID iD: 0000-0002-6312-0291
Russian Federation, Moscow

Maxim A. Bobrov

Moscow Scientific and Practical Center of Dermatology and Venerology and Cosmetology of the Department of Health

Email: m.a.bobrov@yandex.ru
ORCID iD: 0000-0001-7374-0374
SPIN-code: 3058-6092
Russian Federation, Moscow

Dmitry A. Anichkov

Pirogov Russian National Research Medical University

Email: d.anichkov@gmail.com
ORCID iD: 0000-0001-5610-4819
SPIN-code: 2891-6763

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, Moscow

References

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Supplementary files

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1. JATS XML
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2. Fig. 1. Skin signs before starting therapy. Multiple petechial rashes on the skin of the upper and lower extremities, detachment of the upper layers of the epidermis, large-plate peeling

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3. Fig. 2. Hematoxylin-eosin, × 200. In the epidermis — parakeratosis, accumulation of cellular debris in the stratum corneum, acanthosis, spongiosis. In the dermis — extravasations of erythrocytes, edema, perivascular lymphohistiocytic infiltrates

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4. Fig. 3. The same preparation, another field, × 400. Vacuolization of cytoplasm of individual cells of the basal layer

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5. Fig. 4. Dynamics of skin signs during therapy

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Copyright (c) 2024 Somov D.V., Chernyaeva A.Y., Mazus V.A., Nurieva L.T., Bobrov M.A., Anichkov D.A.

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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