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Vitamin A in Stevens-Johnson Syndrome.

L Singer¹, U Brook, M Romem

¹Department of Ophthalmology, Sackler Faculty of Medicine, Tel-Aviv University, Israel.

Annals of Ophthalmology

|June 1, 1989

Summary

A severe adverse reaction to penicillin in a child caused Stevens-Johnson syndrome, leading to ocular complications like dry eye. Topical and systemic Vitamin A treatment successfully regenerated goblet cells and restored tear secretion.

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Area of Science:

Ophthalmology
Pediatrics
Dermatology

Background:

A 9-year-old boy presented with fever and rash after penicillin administration.
The patient developed severe ocular symptoms including photophobia, conjunctivitis, and keratitis.

Observation:

Skin and mucous membrane blistering, eyelid swelling, and pseudomembrane formation on the cornea were noted.
Conjunctival biopsy revealed a complete absence of goblet cells, indicating severe ocular surface damage.
Lacrimal hyposecretion was confirmed by the Schirmer test.

Findings:

The patient experienced significant visual impairment and ocular discomfort.
Aggressive treatment with corticosteroids, antibiotics, and artificial tears provided partial relief.
Topical and systemic Vitamin A administration led to the regeneration of goblet cells and improved tear production.

Implications:

This case highlights the critical importance of early recognition and management of Stevens-Johnson syndrome in pediatric patients.
Vitamin A therapy demonstrates potential efficacy in restoring ocular surface health and function after severe drug-induced reactions.
Ocular complications require prompt and comprehensive treatment to prevent long-term visual impairment.

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