Objective: This case report presents cases of SJS and SJS-TEN in Systemic Lupus Erythematosus (SLE).
Case 1: A 12 years old female came to hospital with a chief complaint of blisters and scalded skin all over her body, hands, feet, and face which had started 2 days prior to admission after consuming herbal medication for 2 days. Additional symptoms were fever, multiple painless oral ulcers, and painful swelling of joints that made patient unable to walk since 3 months prior to admission. On physical examination, general multiple discrete, round, size Æ 0.5 cm–1.2 cm, mostly finely demarcated, some raised, mostly dry, in form of erythema, bullae, erosion, discoid pustules, bullous pustules, and discoid were found. There were ulcerations on oral and genital mucous. Blood examination were performed and hemolytic anemia, positive anti nuclear antibody (ANA) and Anti dsDNA, as well as proteinuria were observed. The patient was diagnosed as suffering from SJS in SLE.
Case 2: A 12 years old female came to hospital with a chief complaint of peeling skin on her body, hands, and face for 1 day prior to admission. This patient was referred by another hospital with cefixime and gentamicin treatment history. On physical examination, there were fever, scaly lesions on body, hands, and face with scalded lesion on the back. There was erosion on lips and oral mucous. Laboratory findings were pancytopenia, positive of direct coomb's test, reactive ANA and high titer Anti dsDNA as well as proteinuria. The patient was then diagnosed as suffering from SJS-TEN in SLE.
Conclusion: Patients when presented with a SJS or SJS-TEN-like picture with SLE background, it becomes difficult to decide whether the eruption is drug induced or a manifestation of lupus itself.
Key word: Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis