Stevens-Johnson syndrome developing in a girl with minimal change nephrotic syndrome on deflazacort therapy

Abstract Rationale Stevens-Johnson syndrome is a vesiculobullous disease of skin and mucosa. This generalized hypersensitivity reaction is well known to occur in association with certain drugs or viral infections. The disease is often treated with corticosteroids. However, corticosteroids induced Stevens-Johnson syndrome have been described. We present a case with nephrotic syndrome who developed cutaneous bullae and mucositis while being treated with oral deflazacort. Case report A 16-year-old girl presented with a 7-month history of recurrent generalized edema and proteinuria. She was diagnosed as minimal change nephritic syndrome. Previously she was treated with prednisolone without adverse drug reactions. 8 weeks prior to admission she developed generalized edema and was treated deflazacort 72mg daily. 1 week prior to admission she developed new eruption involving her face, trunk, and oral mucosa. Laboratory evaluation and virologic test including herpes simplex, Ebstein-Barr virus were all negative. Deflazacort was replaced by daily oral prednisolone 55mg and gradually tapered. Her skin lesion improved over 1 month period. Conclusions We present a patient with Stevens-Johnson syndrome after treatment with deflazacort. It is worth mentioning that our patient was receiving corticosteroids for minimal change nephrotic syndrome and developed the signs and symptoms of Stevens-Johnson syndrome after oral deflazacort. In our patient, deflazcort was considered as a cause because she did not take other medications.