[Stevens-Johnson syndrome and toxic epidermal necrolysis after intake of rifampicin-isoniazid: report of 8 cases in HIV-infected patients in Togo].
Dermatological reactions are frequent drug-related complications in patients with HIV infection. The most serious disorders are Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), a.k.a. Lyell's syndrome, that are potentially fatal. The purpose of this report is to describe 8 cases of SJS/TEN observed in Lomé teaching hospital (Togo) after intake of a combination of rifampicin-isoniazid by HIV-infected patients. There were 5 men and 3 women with a mean age of 28 years. All patients presented AIDS. The disorder was SJS in 3 cases and TEN in 5. In 6 cases, manifestations occurred during initiation of treatment (mean delay for onset, 16 days). In the remaining two cases, manifestations occurred 6 days and 8 days respectively after beginning treatment for recurrent tuberculosis. Mean skin detachment was 8% in patients with SJS and 55.7% in patients with TEN. Five patients including 4 with TEN and 1 with SJS died. This study documents incrimination of combined rifampin-isoniazid treatment in the occurrence of SJS/TEN in patients with HIV infection and confirms the severity and poor prognosis of these disorders. The presence of opportunistic infections such as pulmonary tuberculosis may be an unfavourable prognostic factor in immunocompromised patients with these severe dermatological disorders.
Pitche
P
P
Service de Dermatologie, CHU-Tokoin, Lomé, Togo. ppitche@yahoo.fr
Mouzou
T
T
Padonou
C
C
Tchangai-Walla
K
K
D000328:Adult; D000904:Antibiotics, Antitubercular / Q000009:adverse effects / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D012293:Rifampin / Q000009:adverse effects* / Q000627:therapeutic use; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced* / Q000209:etiology*; D014037:Togo; D014391:Tuberculosis, Miliary / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin