Chemotherapy patient with Stevens-Johnson Syndrome presents to the Emergency Department: A case report

Stevens-Johnson syndrome (SJS) is part of a continuum of severe mucocutaneous reactions, commonly thought to be triggered by certain medications. The syndrome itself is characterized by diffuse necrosis and detachment of the epidermis.

This case report discusses a patient who presented to the Emergency Department with signs and symptoms of Stevens-Johnson syndrome four days after chemotherapy administration of ribociclib (Kisqali®). Ribociclib is a newly approved, cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor indicated for the treatment of hormone receptor positive, human epidermal growth factor receptor 2 negative (HR+/HER2-) metastatic breast cancer. Our case was a 70-year-old female patient with breast cancer who presented four days after her second administration of Ribociclib exhibiting skin findings consistent with SJS. Patient was transferred from the Emergency Department to a burn center for further management and diagnosis was confirmed by biopsy.

While Stevens-Johnson syndrome has been a rare toxicity, it is potentially fatal. The emergency physician should pay special attention cancer patients presenting with suspicious rashes and carefully review their medications.