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[Lyell's disease--a case report].

R Kiszová1, D Cholevík, J Timkovic

  • 1Ocní klinika, FN Ostrava. kiszova.radka@seznam.cz

Ceska a Slovenska Oftalmologie : Casopis Ceske Oftalmologicke Spolecnosti a Slovenske Oftalmologicke Spolecnosti
|December 3, 2011
PubMed
Summary
This summary is machine-generated.

Lyell's disease (Stevens-Johnson syndrome/toxic epidermal necrolysis) can cause severe eye complications. This case report details managing ocular issues, including symblepharon, in a teen following lamotrigine-induced skin reactions.

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Area of Science:

  • Dermatology
  • Ophthalmology
  • Pharmacology

Background:

  • Lyell's disease, a severe mucocutaneous reaction, is often drug-induced and lacks specific treatments.
  • Ocular involvement is common and can lead to significant visual impairment.
  • Interdisciplinary care is crucial for managing this life-threatening condition.

Observation:

  • A 15-year-old male presented with Stevens-Johnson syndrome (SJS) / toxic epidermal necrolysis (TEN) secondary to lamotrigine.
  • He experienced extensive skin involvement (85% body surface area) and severe ocular manifestations, including symblepharon.
  • Initial mild ocular symptoms progressed to severe adhesion, impacting the puncta.

Findings:

  • Treatment involved topical antibiotics, corticosteroids, lubricants, and mechanical lysis of symblepharon.
  • Despite treatment, the patient developed persistent symblepharon obstructing the puncta in both eyes.
  • Long-term follow-up revealed no corneal abnormalities or fornix shortening, with minimal discomfort.

Implications:

  • This case highlights the severe ocular sequelae of drug-induced SJS/TEN, even with prompt management.
  • Effective management requires a multidisciplinary approach, focusing on preventing further adhesion and preserving ocular surface.
  • Long-term ophthalmological monitoring is essential to manage chronic complications like punctal obstruction.