口腔咽喉頭の粘膜病変のみを呈したStevens-Johnson症候群例

抄録

Stevens-Johnson syndrome (SJS) is a hypersensitivity reaction of the skin and mucosa to medications or infection. Herein, we report the case of a 15-year-old boy with SJS who presented with mucous membrane lesions, but without skin lesions. He was admitted with fever, extensively ulcerated and swollen lips, sore throat, and conjunctivitis. He had a one-week history of high fever prior to admission, and had been prescribed an antibiotic with an antipyretic-analgesic by his family doctor. His fever resolved, however, he presented soon thereafter with a 2-day history of mucosal erosions and conjunctivitis. He complained of a sore throat and was unable to swallow. His mouth and pharynx were covered with pseudomembranous lesions. There were no remarkable lesions on the skin. Although skin lesions were absent, the mucosal erosions and conjunctivitis were suggestive of SJS. He was begun on steroid therapy, which led to prompt resolution of the mucosal erosions and conjunctivitis.

Atypical SJS with an absence of skin lesions, but with strongly evident mucosal erosions can occur. The mucosal erosions in the oral cavity rarely are caused by SJS. Therefore, in cases with mucosal erosions, it is always necessary to take into consideration the possibility of SJS.