Abstract

A SERIAL CASE OF 3 TARDIVE COMPLICATIONS OF TOXIC EPIDERMAL NECROLYSIS OVER THE OCULAR SURFACE

*Raharimanantsoa Onja Lalaina, Rajaona Ranto Andriantsilavina, Miray Louis De Gonzague, Ranoasy Njara Francia, Rambeloson Rado and Raobela Léa

Abstract

Introduction: Drug-induced allergic reactions may have different clinical manifestations in which Lyell’s and Stevens- Johnson syndrome are life-threatning. The incidence of drug-induced allergy is estimated at 1 to 5 cases per million person-years. The commonly associated drugs to cause toxic epidermal include sulfonamides, penicillin, anticonvulsant agents, antituberculosis and allopurinol. The complications of Stevens-Johnson (SJS) and Lyell’s syndrome on ocular surface are blinding in the majority of the cases especially if the acute and serious onset is mismanaged. Observations: We encountered three cases of patient presenting ocular complications of toxic epidermal necrolysis in 2018: a 34 years-old female patient, two men of 16 and 28 years-old. The implicated drugs were sulfonamides and penicillins. The ocular lesions were constituted by symblepharons, corneo-conjunctival keratinisation, corneal neovascular proliferation, and corneal opacity. The management is difficult and the visual recovery is not guaranteed. Conclusion: A particular cautious is to be considered before prescribing high risk drugs.

Keywords: Drug-induced allergy, Lyell, Stevens-Johnson, ocular surface, symblepharon.