Paracetamol induced Steven-Johnson syndrome: A rare case
The present case has been reported in the journal Contemporary Clinical Dentistry.

A 14-year-old male patient reported with a chief complaint of painful ulceration of lips and oral cavity leading to difficulty in opening mouth and eating food since 5 days. History of present illness revealed that there was burning sensation followed by ulcers which appeared first in oral cavity, lips, and other parts of body including chest, arms, legs and thighs, and genital organs.

The redness of eye was evident, and there was a history of watery discharge. Numerous healed lesions were also seen on the chest, axilla which gave the typical appearance of “target lesions” or “bull's eye “appearance”

The past medical history revealed that the patient was suffering from fever and pain since 2 weeks. The patient was prescribed tablet crocin for fever and pain for 7 days by a local medical practitioner. The patient was relieved from fever and pain but later he had burning sensation followed by ulcers in the oral cavity and extra-oral surface.

Intra-oral examination revealed a solitary mixed red and white lesion present on both right and left buccal mucosa. On left buccal mucosa it measured 10 mm × 8 mm in diameter and right side about 16 mm × 9 mm approximately.

The patient was treated under an expert guidance of dermatologist with systemic steroids; tablet prednisolone 30 mg twice daily daily for 7 days. Further reduced to 20 mg twice daily for next 7 days. Gradually, 10 mg and 5 mg for consecutive 7 days were administered. Gentian violet application 3 times daily for lips and skin lesions was advocated.

Application of Kenacort (triamcinolone) ointment thrice a day was advised for ulcers in the oral cavity. The patient was reviewed after a week. Lesions had healed significantly in the oral cavity and on the skin. Recall after 2 weeks revealed almost resolved lesions on all the surfaces and completely recovered approximately in 40 days.

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