Clinical cases of Stevens-Johnson syndrome caused by carbamazepine use

Dhroso Holta

https://dx.doi.org/10.51350/zdravkg2025.4.12.2.17.26

Clinical cases of Stevens-Johnson syndrome caused by carbamazepine use

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Abstract About the authors References

Abstract

Introduction. Stevens-Johnson syndrome (SJS) is a rare, predominantly drug-induced, life-threatening, acute skin and mucous membrane disorder classified as an acute, severe toxic-allergic disease. This manifestation of a delayed-type hypersensitivity reaction represents a severe variant of erythema multiforme, in which, along with skin lesions, mucosal lesions (of at least two organs) are observed. The incidence of SSc progressing to a severe form worldwide averages the incidence is 1.3 cases per million population, with a mortality rate reaching 10%. The disease can be triggered by various infections, cancer, and other conditions. In 50% of cases, the cause of SSD remains unknown. Drug allergies are of particular importance in the development of SSc, since for most drugs the risk of sensitization ranges from 1 to 3%. The main drugs that can lead to the development of SSc are antibiotics, non-steroidal anti-inflammatory drugs, local anesthetics, antiepileptic drugs, barbiturates, and vaccines. A drug-related cause can be established if the condition occurs within the first 4 weeks of treatment. Stevens-Johnson syndrome is currently considered a severe pathological process characterizedby high mortality, making it a serious clinical and dermatological problem requiring timely diagnosis and intensive treatment. The mortality rate from Stevens-Johnson syndrome is 5–12%. Advanced age and the presence of comorbidities are significant risk factors that increase mortality. Study objective: To describe the clinical course and treatment of SSc as a complication following carbamazepine administration and to outline preventive measures. Materials and methods. Two clinical cases of carbamazepine-induced Stevens-Johnson syndrome are presented in patients treated in the dermatology department of the Republican Center for Dermatovenereology (RCDV). The patients were hospitalized in August–September 2025 (informed consent was obtained from patients). Results and discussion. Patients were clinically monitored at the Russian Center for Child Welfare and received treatment for 10 days. Following this, the dynamics of clinical manifestations were described with a detailed photo report. Similar to other countries, in Kyrgyzstan, diagnosis and timely treatment of Stevens-Johnson syndrome are a challenge. Estimating specific statistics and the prevalence of the disease in Kyrgyzstan is difficult due to limited data availability. However, taking into account general global trends, it can be assumed that patients taking certain groups of drugs are at increased risk. It is important for physicians and patients to be aware of the potential for drug reactions and the need to seek immediate medical attention at the first sign of symptoms. Conclusion. All healthcare professionals should strictly avoid re-prescribing carbamazepine to patients with a history of Stevens-Johnson syndrome or other severe cutaneous adverse reactions associated with its use.

About the authors

Дхросо Холта, врач-дерматовенеролог, заведующая детским отделением дерматологии Республиканского Центра Дерматовенерологии, Бишкек, кыргызская Республика

Шакирова Айнура Таласбаевна, ассистент кафедры дерматовенерологии Кыргызской государственной медицинской академии им. И.К. Ахунбаева, Бишкек, Кыргызская Республика

Койбагарова Асель Алмазбековна, доктор медицинских наук, доцент, зав. кафедры дерматовенерологии Кыргызской государственной медицинской академии им. И.К. Ахунбаева, Бишкек, Кыргызская Республика

Суранбаева Айчурок Курманбековна, врач-дерматовенеролог, Республиканского Центра Дерматовенерологии, Бишкек, Кыргызская Республика

Жапарова Аида Калачиевна, заместитель главного врача, заведующая консультативным отделением Республиканского Центра Дерматовенерологии, Бишкек, Кыргызская Республика

Dhroso Kholta, dermatovenerologist, head of the pediatric dermatology department of the Republican Center for Dermatovenerology, Bishkek, Kyrgyz Republic

Shakirova Ainura Talasbaevna, Assistant Professor, Department of Dermatovenereology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic

Koybagarova Asel Almazbekovna, Doctor of Medical Sciences, Associate Professor, Head of the Department of Dermatovenereology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic

Suranbaeva Aichurok Kurmanbekovna, dermatovenerologistRepublican Center for Dermatovenereology, Bishkek, Kyrgyz Republic

Japarova Aida Kalachievna, Deputy Chief Physician, Head of the Consultative Department of the Republican Center for Dermatovenereology, Bishkek, Kyrgyz Republic

Дросо Холта, дерматовенеролог, Республикалык дерматовенерология борборунун балдар дерматологиясы бөлүмүнүн башчысы, Бишкек, Кыргыз Республикасы

Шакирова Айнура Таласбаевна, дерматовенерология кафедрасынын ассистент-профессору, И.К. Ахунбаев атындагы Кыргыз мамлекеттик медициналык академиясы, Бишкек, Кыргыз Республикасы

Койбагарова Асел Алмазбековна, медицина илимдеринин доктору, доцент, И.К. Ахунбаев атындагы Кыргыз мамлекеттик медициналык академиясынын дерматовенерология кафедрасынын башчысы, Бишкек, Кыргыз Республикасы

Суранбаева Айчүрөк Курманбековна, дерматовенеролог, Республикалык дерматовенерология борборунун, Бишкек, Кыргыз Республикасы

Жапарова Аида Калачиевна, башкы дарыгердин орун басары, Республикалык дерматовенерология борборунун консультациялык бөлүмүнүн башчысы, Бишкек, Кыргыз Республикасы

References

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4. Yousef S. Abuzneid, Hussam I. A. Alzeerelhouseini, Duha Rabi, Ihab Hilail, Hatem Rjoob, Abdelrahman Rabee, Naser Amro, Qutaiba Qafisheh, Mohammad Kharraz Carbamazepine Induced Stevens-Johnson Syndrome That Developed into Toxic Epidermal Necrolysis: Review of the Literature First published: 06 May 2022, https://doi.org/10.1155/2022/6128688
https://onlinelibrary.wiley.com/doi/10.1155/2022/6128688
5. Authors Shih-Chi Su, Wen-Hung Chung Update on pathobiology in Stevens-Johnson syndrome and toxic epidermal necrolysis, December 2013 DOI:10.1016/j.dsi.2013.09.002 License CC BY-NC-ND 4.0 https://www.researchgate.net/publication/25914133
3_Update_on_pathobiology_in_StevensJohnson_syndrome_and_toxic_ epidermal_necrolysis?_tp=eyJjb250ZXh0Ijp7ImZpcnN0U GFnZSI6Il9kaXJlY3QiLCJwYWdlIjoiX2RpcmVjdCJ9fQ
6. Author: C Stephen Foster, MD, FACS, FACR, FAAO, FARVO; Chief Editor: Andrew A Dahl, MD, FACS, Stevens-Johnson Syndrome, Updated: Dec 18, 2024 https://emedicine.medscape.com/article/1197450-overview
7. Author: Lu Zhou, Yun Lu, Ya Zou, Hua Wei, Xirui Guo, Qinchuan Li, Yan Zhou, Xiaotian Zhao, Fangqing Xie, Liwen Zhang, Drug-induced Stevens–Johnson syndrome and toxic epidermal necrolysis: a 10-year retrospective study of 103 cases Get access Arrow, Published: 20 June 2025, https://academic.oup.com/ced/article-abstract/50/11/2200/8170029?redirectedFrom=fulltext
8. Tejas K Patel 1, Manish J Barvaliya, Dineshchandra Sharma, Chandrabhanu Tripathi, A systematic review of the drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Indian population, 2013 May-Jun https://pubmed.ncbi.nlm.nih.gov/23619444/
9. A. Avinash, V. Mohanbabu Amberkar, Sushil Kiran Kunder, Sharath Madhyastha, K Meenakumari, Carbamazepine- Life-threatening Stevens-Johnson Syndrome and Agranulocytosis: The Maiden Case, 2016 Dec https://pmc.ncbi.nlm.nih.gov/articles/PMC5296452/
10. Authors: Arvind Kumar, Dinesh Kansal, Usha Kumari Chaudhary, Ajay Sharma, Reena Sharma, Carbamazepine-induced Stevens Johnson syndrome: a case series of three case reports, July-August 2015, https://www.ijbcp.com/index.php/ijbcp/article/view/845?utm_source=chatgpt.com;
11. Горячкина Л.А., Кашкин К.П. Клиническая аллергология и иммунология. Руководство для практикующих врачей. М.:Миклош, 2009. С. 222–271.
12. Sukasem C., Puangpetch A., Medhasi S., Tassaneeyakul W. Pharmacogenomics of drug-induced hypersensitivity reactions: challenges, opportunities and clinical implementation // Asian Pac. J. Allergy Immunol. 2014. Vol. 32. № 2. P. 111–123.
13. Kaniwa N., Saito Y. The risk of cutaneous adverse reactions among patients with the HLA-A* 31:01 who given carbamazepine, oxcarbazepine or eslicarbazepine: a perspective review // Ther. Adv. Drug. Saf. 2013. Vol. 4. № 6. P. 246–253.
14. Mehta M., Shah J., Khakhkhar T. et al. Anticonvulsant hypersensitivity syndrome associated with carbamazepine administration: Case series // J. Pharmacol. Pharmacother. 2014. Vol. 5. № 1. P. 59–62.
15. Amstutz U., Shear N.H., Rieder M.J. et al. Recommendations for HLA-B*15:02 and HLA-A*31:01 genetic testing to reduce the risk of carbamazepine-induced hypersensitivity reactions // Epilepsia. 2014. Vol. 55. № 4. P. 496–506.

1. D. Creamer, S.A. Walsh, P. Dziewulski, L.S. Exton, H.Y. Lee, J.K.G. Dart, J. Setterfield, C.B. Bunker, M.R. Ardern-Jones, K.M.T. Watson, G.A.E. Wong, M. Philippidou, A. Vercueil .U.K. guidelines for the management of Stevens–Johnson syndrome/toxic epidermal necrolysis in adults 2016, 18 June 2016, https://doi.org/10.1111/bjd.14530, https://onlinelibrary.wiley.com/doi/full/10.111/bjd.14 530
2. Российское общество дерматовенерологов и косметологов Синдром Стивенса-Джонсона 2020, https://www.rodv.ru › upload› iblock
3. Indian J Dermatol, Rajesh Kumar 1,✉, Anupam Das 1, Sudip Das 2 Management of Stevens-Johnson Syndrome-Toxic Epidermal Necrolysis: Looking Beyond Guidelines, 2018 Mar-Apr., doi:10.4103/ijd.IJD_583_17
4. Yousef S. Abuzneid, Hussam I. A. Alzeerelhouseini, Duha Rabi, Ihab Hilail, Hatem Rjoob, Abdelrahman Rabee, Naser Amro, Qutaiba Qafisheh, Mohammad Kharraz Carbamazepine Induced Stevens-Johnson Syndrome That Developed into Toxic Epidermal Necrolysis: Review of the Literature First published: 06 May 2022, https://doi.org/10.1155/2022/6128688
https://onlinelibrary.wiley.com/doi/10.1155/2022/6128688
5. Authors Shih-Chi Su, Wen-Hung Chung Update on pathobiology in Stevens-Johnson syndrome and toxic epidermal necrolysis, December 2013 DOI:10.1016/j.dsi.2013.09.002 License CC BY-NC-ND 4.0 https://www.researchgate.net/publication/25914133
3_Update_on_pathobiology_in_StevensJohnson_syndrome_and_toxic_ epidermal_necrolysis?_tp=eyJjb250ZXh0Ijp7ImZpcnN0U GFnZSI6Il9kaXJlY3QiLCJwYWdlIjoiX2RpcmVjdCJ9fQ
6. Author: C Stephen Foster, MD, FACS, FACR, FAAO, FARVO; Chief Editor: Andrew A Dahl, MD, FACS, Stevens-Johnson Syndrome, Updated: Dec 18, 2024 https://emedicine.medscape.com/article/1197450-overview
7. Author: Lu Zhou, Yun Lu, Ya Zou, Hua Wei, Xirui Guo, Qinchuan Li, Yan Zhou, Xiaotian Zhao, Fangqing Xie, Liwen Zhang, Drug-induced Stevens–Johnson syndrome and toxic epidermal necrolysis: a 10-year retrospective study of 103 cases Get access Arrow, Published: 20 June 2025, https://academic.oup.com/ced/article-abstract/50/11/2200/8170029?redirectedFrom=fulltext
8. Tejas K Patel 1, Manish J Barvaliya, Dineshchandra Sharma, Chandrabhanu Tripathi, A systematic review of the drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Indian population, 2013 May-Jun https://pubmed.ncbi.nlm.nih.gov/23619444/
9. A. Avinash, V. Mohanbabu Amberkar, Sushil Kiran Kunder, Sharath Madhyastha, K Meenakumari, Carbamazepine- Life-threatening Stevens-Johnson Syndrome and Agranulocytosis: The Maiden Case, 2016 Dec https://pmc.ncbi.nlm.nih.gov/articles/PMC5296452/
10. Authors: Arvind Kumar, Dinesh Kansal, Usha Kumari Chaudhary, Ajay Sharma, Reena Sharma, Carbamazepine-induced Stevens Johnson syndrome: a case series of three case reports, July-August 2015, https://www.ijbcp.com/index.php/ijbcp/article/view/845?utm_source=chatgpt.com;
11. Горячкина Л.А., Кашкин К.П. Клиническая аллергология и иммунология. Руководство для практикующих врачей. М.:Миклош, 2009. С. 222–271.
12. Sukasem C., Puangpetch A., Medhasi S., Tassaneeyakul W. Pharmacogenomics of drug-induced hypersensitivity reactions: challenges, opportunities and clinical implementation // Asian Pac. J. Allergy Immunol. 2014. Vol. 32. № 2. P. 111–123.
13. Kaniwa N., Saito Y. The risk of cutaneous adverse reactions among patients with the HLA-A* 31:01 allele who are given carbamazepine, oxcarbazepine or eslicarbazepine: a perspective review // Ther. Adv. Drug. Saf. 2013. Vol. 4. № 6. P. 246–253.
14. Mehta M., Shah J., Khakhkhar T. et al. Anticonvulsant hypersensitivity syndrome associated with carbamazepine administration: Case series // J. Pharmacol. Pharmacother. 2014. Vol. 5. № 1. P. 59–62.
15. Amstutz U., Shear N.H., Rieder M.J. et al. Recommendations for HLA-B*15:02 and HLA-A*31:01 genetic testing to reduce the risk of carbamazepine-induced hypersensitivity reactions // Epilepsia. 2014. Vol. 55. № 4. P. 496–506.

Keywords

Clinical case , Stevens-Johnson syndrome , SJS-TEN , Toxic epidermal necrolysis

Для цитирования

Дхросо Холта, Шакирова А.Т., Койбагарова А.А., Суранбаева А.К., Жапарова А.К. Клинические случаи синдрома Стивенса – Джонсона, вызванного применением карбамазепина. Научно-практический «Здравоохранение Кыргызстана» 2025, № 4, с.17-26. https://dx.doi.org/10.51350/zdravkg2025.4.12.2.17.26

For citation

Dhroso Holta, Shakirova A.T., Koibagarova A.A., Suranbaeva A.K., Zhaparova A.K., Clinical cases of Stevens-Johnson syndrome caused by carbamazepine use.Scientific and practical journal “Health care of Kyrgyzstan” 2025, No. 4, p. 17-26. https://dx.doi.org/10.51350/zdravkg2025.4.12.2.17.26

Цитата үчүн

Дхросо Холта, Шакирова А.Т., Койбагарова А.А., Суранбаева А.К., Жапарова А.К. Карбамазепин менен шартталган Стивенс-Джонсон синдромунун клиникалык учурлары. "Кыргызстандын саламаттык сактоо" илимий-практикалык журналы 2025, № 4 б. 17-26. https://dx.doi.org/10.51350/zdravkg2025.4.12.2.17.26

Authors Dhroso Holta, Shakirova A.T., Koibagarova A.A., Zhaparova А.К. , Suranbaeva A.K.

Link doi.org https://dx.doi.org/10.51350/zdravkg2025.4.12.2.17.26

Pages 17-26

Keywords Clinical case, Stevens-Johnson syndrome, SJS-TEN, Toxic epidermal necrolysis

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About authors

Dhroso Kholta, dermatovenerologist, head of the pediatric dermatology department of the Republican Center for Dermatovenerology, Bishkek, Kyrgyz Republic

Shakirova Ainura Talasbaevna, Assistant Professor, Department of Dermatovenereology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic

Koybagarova Asel Almazbekovna, Doctor of Medical Sciences, Associate Professor, Head of the Department of Dermatovenereology, I.K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic

Suranbaeva Aichurok Kurmanbekovna, dermatovenerologistRepublican Center for Dermatovenereology, Bishkek, Kyrgyz Republic

Japarova Aida Kalachievna, Deputy Chief Physician, Head of the Consultative Department of the Republican Center for Dermatovenereology, Bishkek, Kyrgyz Republic

Full text

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References

1. D. Creamer, S.A. Walsh, P. Dziewulski, L.S. Exton, H.Y. Lee, J.K.G. Dart, J. Setterfield, C.B. Bunker, M.R. Ardern-Jones, K.M.T. Watson, G.A.E. Wong, M. Philippidou, A. Vercueil .U.K. guidelines for the management of Stevens–Johnson syndrome/toxic epidermal necrolysis in adults 2016, 18 June 2016, https://doi.org/10.1111/bjd.14530, https://onlinelibrary.wiley.com/doi/full/10.111/bjd.14 530
2. Российское общество дерматовенерологов и косметологов Синдром Стивенса-Джонсона 2020, https://www.rodv.ru › upload› iblock
3. Indian J Dermatol, Rajesh Kumar 1,✉, Anupam Das 1, Sudip Das 2 Management of Stevens-Johnson Syndrome-Toxic Epidermal Necrolysis: Looking Beyond Guidelines, 2018 Mar-Apr., doi:10.4103/ijd.IJD_583_17
4. Yousef S. Abuzneid, Hussam I. A. Alzeerelhouseini, Duha Rabi, Ihab Hilail, Hatem Rjoob, Abdelrahman Rabee, Naser Amro, Qutaiba Qafisheh, Mohammad Kharraz Carbamazepine Induced Stevens-Johnson Syndrome That Developed into Toxic Epidermal Necrolysis: Review of the Literature First published: 06 May 2022, https://doi.org/10.1155/2022/6128688
https://onlinelibrary.wiley.com/doi/10.1155/2022/6128688
5. Authors Shih-Chi Su, Wen-Hung Chung Update on pathobiology in Stevens-Johnson syndrome and toxic epidermal necrolysis, December 2013 DOI:10.1016/j.dsi.2013.09.002 License CC BY-NC-ND 4.0 https://www.researchgate.net/publication/25914133
3_Update_on_pathobiology_in_StevensJohnson_syndrome_and_toxic_ epidermal_necrolysis?_tp=eyJjb250ZXh0Ijp7ImZpcnN0U GFnZSI6Il9kaXJlY3QiLCJwYWdlIjoiX2RpcmVjdCJ9fQ
6. Author: C Stephen Foster, MD, FACS, FACR, FAAO, FARVO; Chief Editor: Andrew A Dahl, MD, FACS, Stevens-Johnson Syndrome, Updated: Dec 18, 2024 https://emedicine.medscape.com/article/1197450-overview
7. Author: Lu Zhou, Yun Lu, Ya Zou, Hua Wei, Xirui Guo, Qinchuan Li, Yan Zhou, Xiaotian Zhao, Fangqing Xie, Liwen Zhang, Drug-induced Stevens–Johnson syndrome and toxic epidermal necrolysis: a 10-year retrospective study of 103 cases Get access Arrow, Published: 20 June 2025, https://academic.oup.com/ced/article-abstract/50/11/2200/8170029?redirectedFrom=fulltext
8. Tejas K Patel 1, Manish J Barvaliya, Dineshchandra Sharma, Chandrabhanu Tripathi, A systematic review of the drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Indian population, 2013 May-Jun https://pubmed.ncbi.nlm.nih.gov/23619444/
9. A. Avinash, V. Mohanbabu Amberkar, Sushil Kiran Kunder, Sharath Madhyastha, K Meenakumari, Carbamazepine- Life-threatening Stevens-Johnson Syndrome and Agranulocytosis: The Maiden Case, 2016 Dec https://pmc.ncbi.nlm.nih.gov/articles/PMC5296452/
10. Authors: Arvind Kumar, Dinesh Kansal, Usha Kumari Chaudhary, Ajay Sharma, Reena Sharma, Carbamazepine-induced Stevens Johnson syndrome: a case series of three case reports, July-August 2015, https://www.ijbcp.com/index.php/ijbcp/article/view/845?utm_source=chatgpt.com;
11. Горячкина Л.А., Кашкин К.П. Клиническая аллергология и иммунология. Руководство для практикующих врачей. М.:Миклош, 2009. С. 222–271.
12. Sukasem C., Puangpetch A., Medhasi S., Tassaneeyakul W. Pharmacogenomics of drug-induced hypersensitivity reactions: challenges, opportunities and clinical implementation // Asian Pac. J. Allergy Immunol. 2014. Vol. 32. № 2. P. 111–123.
13. Kaniwa N., Saito Y. The risk of cutaneous adverse reactions among patients with the HLA-A* 31:01 allele who are given carbamazepine, oxcarbazepine or eslicarbazepine: a perspective review // Ther. Adv. Drug. Saf. 2013. Vol. 4. № 6. P. 246–253.
14. Mehta M., Shah J., Khakhkhar T. et al. Anticonvulsant hypersensitivity syndrome associated with carbamazepine administration: Case series // J. Pharmacol. Pharmacother. 2014. Vol. 5. № 1. P. 59–62.
15. Amstutz U., Shear N.H., Rieder M.J. et al. Recommendations for HLA-B*15:02 and HLA-A*31:01 genetic testing to reduce the risk of carbamazepine-induced hypersensitivity reactions // Epilepsia. 2014. Vol. 55. № 4. P. 496–506.

For citation

Kyrgyz

Авторлор жөнүндө

Шилтемелер

1. D. Creamer, S.A. Walsh, P. Dziewulski, L.S. Exton, H.Y. Lee, J.K.G. Dart, J. Setterfield, C.B. Bunker, M.R. Ardern-Jones, K.M.T. Watson, G.A.E. Wong, M. Philippidou, A. Vercueil .U.K. guidelines for the management of Stevens–Johnson syndrome/toxic epidermal necrolysis in adults 2016, 18 June 2016, https://doi.org/10.1111/bjd.14530, https://onlinelibrary.wiley.com/doi/full/10.111/bjd.14 530
2. Российское общество дерматовенерологов и косметологов Синдром Стивенса-Джонсона 2020, https://www.rodv.ru › upload› iblock
3. Indian J Dermatol, Rajesh Kumar 1,✉, Anupam Das 1, Sudip Das 2 Management of Stevens-Johnson Syndrome-Toxic Epidermal Necrolysis: Looking Beyond Guidelines, 2018 Mar-Apr., doi:10.4103/ijd.IJD_583_17
4. Yousef S. Abuzneid, Hussam I. A. Alzeerelhouseini, Duha Rabi, Ihab Hilail, Hatem Rjoob, Abdelrahman Rabee, Naser Amro, Qutaiba Qafisheh, Mohammad Kharraz Carbamazepine Induced Stevens-Johnson Syndrome That Developed into Toxic Epidermal Necrolysis: Review of the Literature First published: 06 May 2022, https://doi.org/10.1155/2022/6128688
https://onlinelibrary.wiley.com/doi/10.1155/2022/6128688
5. Authors Shih-Chi Su, Wen-Hung Chung Update on pathobiology in Stevens-Johnson syndrome and toxic epidermal necrolysis, December 2013 DOI:10.1016/j.dsi.2013.09.002 License CC BY-NC-ND 4.0 https://www.researchgate.net/publication/25914133
3_Update_on_pathobiology_in_StevensJohnson_syndrome_and_toxic_ epidermal_necrolysis?_tp=eyJjb250ZXh0Ijp7ImZpcnN0U GFnZSI6Il9kaXJlY3QiLCJwYWdlIjoiX2RpcmVjdCJ9fQ
6. Author: C Stephen Foster, MD, FACS, FACR, FAAO, FARVO; Chief Editor: Andrew A Dahl, MD, FACS, Stevens-Johnson Syndrome, Updated: Dec 18, 2024 https://emedicine.medscape.com/article/1197450-overview
7. Author: Lu Zhou, Yun Lu, Ya Zou, Hua Wei, Xirui Guo, Qinchuan Li, Yan Zhou, Xiaotian Zhao, Fangqing Xie, Liwen Zhang, Drug-induced Stevens–Johnson syndrome and toxic epidermal necrolysis: a 10-year retrospective study of 103 cases Get access Arrow, Published: 20 June 2025, https://academic.oup.com/ced/article-abstract/50/11/2200/8170029?redirectedFrom=fulltext
8. Tejas K Patel 1, Manish J Barvaliya, Dineshchandra Sharma, Chandrabhanu Tripathi, A systematic review of the drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Indian population, 2013 May-Jun https://pubmed.ncbi.nlm.nih.gov/23619444/
9. A. Avinash, V. Mohanbabu Amberkar, Sushil Kiran Kunder, Sharath Madhyastha, K Meenakumari, Carbamazepine- Life-threatening Stevens-Johnson Syndrome and Agranulocytosis: The Maiden Case, 2016 Dec https://pmc.ncbi.nlm.nih.gov/articles/PMC5296452/
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