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Conjunctival pigmentation in Stevens-Johnson syndrome
Graciana Fuentes-Páez1, Maria C Mendez, Javier Montañez
1IOBA (Institute of Ophthalmobiology), University of Valladolid, Ramón y Cajal 7, Valladolid, 47005, Spain.
Stevens-Johnson syndrome (SJS) can cause conjunctival pigmentation due to melanin, not drug deposition. This rare side effect persisted despite treatment, highlighting long-term ocular complications of SJS.
Area of Science:
- Ophthalmology
- Dermatology
- Pathology
Background:
- Stevens-Johnson syndrome (SJS) is a severe mucocutaneous reaction.
- Sulfasalazine is a known trigger for SJS.
- Ocular manifestations of SJS can be severe and long-lasting.
Purpose of the Study:
- To report a case of conjunctival pigmentation following sulfasalazine-induced SJS.
- To investigate the etiology of the observed conjunctival pigmentation.
- To evaluate the treatment response for SJS-related ocular complications.
Main Methods:
- Clinical case presentation of a 29-year-old female.
- Ocular examination including biopsy of conjunctival tissue.
- Histopathological analysis to determine pigment origin.
- Assessment of treatment outcomes with topical steroids and artificial tears.
Main Results:
- The patient developed bilateral conjunctival pigmentation after SJS triggered by sulfasalazine.
- Biopsy confirmed melanic pigment and stromal monocyte infiltration, indicative of chronic SJS.
- Pigmentation was not attributed to drug deposition.
- Clinical symptoms improved with topical steroids and artificial tears, but pigmentation remained unchanged after two years.
Conclusions:
- Conjunctival pigmentation in SJS can be of melanic origin.
- This pigmentation may represent a persistent sequela of chronic SJS.
- Ocular surface management is crucial, though pigmentary changes may be irreversible.
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