Today for conference we presented a case of a patient on polypharmacy presenting with diffuse targetoid rash involving palms, after discussing DDx for rashes involving palms the patient developed mucositis and some of their papules developed into vesicles triggering a diagnosis of Steven-Johnson Syndrome (SJS) which was confirmed by biopsy. We also discussed care of these patient including prevention of long term-sequelae. Slides (with a lot of pictures) can be found here SJS – 1.6
Take home points:
- Describe a differential diagnosis of palmar rashes and vesiculobullous rash
- Rash with mucositis narrows that differential..
- SJS / TEN are severe mucocutaneous reactions, most commonly triggered by medications, mucosal involvement is very common
- Treatment is mostly supportive and withdrawal of causative medication