The Importance of Accurate Anamnesis in Determining Suspected Drugs Causing of Oral Manifestation of Stevens Johnson Syndrome-Toxic Epidermal Necrolysis (Case Report)

• DOI: 10.7454/uiphm.v1i0.20
• Publication Date: 2017-01-09T03:28:13Z
• Authors: Selvia Selvia; Indriasti I Wardhany
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

<p class="AbstractContent"><strong>Introduction</strong>: Stevens - Johnson Syndrome (SJS) and Toxic epidermal necrolysis (TEN) are drug hypersensitivity life-threatening disease that involve skin and mucous membrane. Oral manifestation occurs in almost all the patients of SJS-TEN.</p><p class="AbstractContent"><strong>Case report:</strong> A 52-years-old SJS-TEN female patient was referred from department of dermatology and venereology of RSCM hospital, Jakarta to the department of oral medicine, because of the painful ulcers in the mouth and difficulty to eat. Severe loss of integrity lesions was found in lips and oral mucosa. The causing drugs cannot be identified earlier because of challenging condition during anamnesis. The leading clue of suspected causative drugs was conducted by oral medicine specialist with in depth anamnesis of thorough patients’ medical history. Allergic test after six-week period after the patient first visit shows positive result of carbamazepine and amitriptyline hypersensitivity.</p><p class="AbstractContent"><strong>Discussion</strong>: The delayed in determining causing drugs in this case were because of several causes, especially lack of information gain during anamnesis. In the condition when the operator cannot obtain sufficient information due to patient condition, it was very important to have an excellent communication in the collaborating medical team and patient family as well as constantly obtaining new important information during the ongoing treatment. Since the appropriate and successful treatment was depending in determining an exact cause, the anamnesis plays a critical role in this case.</p><p class="AbstractContent"><strong>Conclusion:</strong> Accurate anamnesis by operator was an important part regarding the successful management of patient with SJS-TEN since the disease has an enormous impact in patient’s quality of life.</p>