Recurrent Steven-Johnson/Toxic Epidermal Necrolysis Overlap Syndrome

Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening mucocutaneous reactions that are predominantly drug-induced. Treatment varies depending on the severity, but even with accurate medical management, the mortality rate can be up to 50% in severe cases. Recurrent episodes with different agents are uncommon, but they have been reported in the literature. We present a case of a 30-year-old female presenting with recurrent SJS/TEN overlap syndrome complicated by sepsis after phenytoin use. Records revealed a previous episode after carbamazepine use one month prior to the current presentation and a first episode 23 years ago with an unknown medication. The offending agent was discontinued, the appropriate treatment was given, and the patient’s clinical status significantly improved. This case highlights the life-threatening manifestation of a mucocutaneous reaction. Prompt clinical assessment is paramount for patient survival.