Abstract

A RARE CASE OF FIXED-DOSE COMBINATION OF NONSTEROIDAL ANTI-INFLAMMATORY DRUG INDUCED STEVENS–JOHNSON SYNDROME

Sagar Chidanand Duganavar*, Justina Princess G., Dr. Pankaj Kumar Masare, Harsha M Naikwad

ABSTRACT

Stevens–Johnson syndrome (SJS) is a rare but life-threatening mucocutaneous hypersensitivity reaction most commonly triggered by medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently implicated because of their widespread use. We report a rare case of SJS following the intake of a fixed-dose combination of Ibuprofen, Paracetamol, and Caffeine in a 38-year-old male. The patient developed erythematous lesions over the back, which progressed to fluid-filled bullae involving the trunk and extremities along with mucosal involvement. Histopathological examination confirmed the diagnosis. Causality assessment using Naranjo’s scale yielded a score of seven, indicating a probable relationship with the suspected drug, while Hartwig’s severity scale indicated level four, suggesting moderate severity. The patient was treated with systemic corticosteroids, antibiotics, antiviral therapy, and supportive care, resulting in gradual improvement. This case highlights the cautious use of over-the-counter fixed-dose combinations.

Keywords: Stevens–Johnson syndrome, NSAIDs, Ibuprofen, adverse drug reaction, pharmacovigilance.