Royal College of Surgeons in Ireland
Browse

Isolated ocular Stevens–Johnson Syndrome caused by lymecycline in a patient with underlying ulcerative colitis

Download (795.32 kB)
journal contribution
posted on 2024-01-10, 17:01 authored by Christine M Bourke, Brendan K Cummings, Daire J Hurley, Conor MurphyConor Murphy, Sarah Chamney
Stevens–Johnson syndrome (SJS) and the more severe variant, toxic epidermal necrolysis (TEN), are a spectrum of mucocutaneous reactions with potentially devastating ocular consequences. Ocular complications occur in about 70% of patients with Stevens–Johnson syndrome, and 35% continue with chronic disease. We report an unusual presentation of isolated ocular Stevens–Johnson syndrome in a patient with recently diagnosed ulcerative colitis being treated with Infliximab. The case had an insidious and atypical onset and represented a diagnostic dilemma. The diagnosis was more difficult, due to the fact that the inciting agent had long been stopped. Severe bacterial conjunctivitis such as that caused by Chlamydia Trachomatis, Corynebacterium diphtheria, and Neisseria Gonorrhea can cause forniceal shortening and symblepharon; this diagnosis was ruled out with microbiological swabs. A conjunctival biopsy was the key to diagnosis. Treatment involved high-dose IV steroids and dual immunosuppression with Infliximab and mycophenolate mofetil. We sought to employ interventions with the greatest impacts on our patient’s condition. Our experience contributes to the growing evidence supporting intensive ophthalmic management of SJS to prevent long-term vision loss.

History

Data Availability Statement

No new data were created or analyzed in this study. Data sharing is not applicable to this article

Comments

The original article is available at https://www.mdpi.com/

Published Citation

Bourke CM, Cummings BK, Hurley DJ, Murphy CC, Chamney S. Isolated ocular Stevens-Johnson Syndrome caused by lymecycline in a patient with underlying ulcerative colitis. J Clin Med. 2023;12(16):5259.

Publication Date

12 August 2023

PubMed ID

37629300

Department/Unit

  • Ophthalmology
  • School of Pharmacy and Biomolecular Sciences

Research Area

  • Health Professions Education
  • Chemistry and Pharmaceutical Sciences
  • Biomaterials and Regenerative Medicine
  • Surgical Science and Practice
  • Immunity, Infection and Inflammation

Publisher

MDPI AG

Version

  • Published Version (Version of Record)