Case report: Successful immunomodulators combined with electromagnetic field therapy in a patient with methazolamide-induced Steven Johnson syndrome/toxic epidermal necrolysis overlap

Front Med (Lausanne). 2023 May 25:10:1192920. doi: 10.3389/fmed.2023.1192920. eCollection 2023.

Abstract

Methazolamide is used to treat patients with glaucoma. However, as a sulfonamide derivative, methazolamide shares the same adverse reaction profile as other sulfa-based medications. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare delayed-type hypersensitivity cutaneous reactions with high morbidity and mortality. Here, we report a severe SJS/TEN overlap syndrome in an 85-year-old Chinese male patient who received methazolamide 25 mg twice daily for his left eye glaucoma. The causal relationship between SJS/TEN and methazolamide was categorized as "highly likely" on the algorithm for assessing drug causality for epidermal necrolysis. In addition to the treatments with methylprednisolone and immunoglobulin, we used a special electromagnetic spectrum therapeutic apparatus to provide skin wound care. The patient had a thoroughly satisfying recovery. This is the first case report to use electromagnetic field therapy in a patient with SJS/TEN. We share our experience here and suggest that electromagnetic field therapy can provide advanced skin wound care and facilitate the recovery of SJS/TEN.

Keywords: Steven Johnson syndrome; adverse drug reaction; case report; electromagnetic field therapy; methazolamide; toxic epidermal necrolysis.

Publication types

  • Case Reports

Grants and funding

This study was supported by the Natural Science Key Project of Bengbu Medical College (BYKY2019054ZD), the Undergraduate Innovation and Entrepreneurship Training Program of Bengbu Medical College (bydc2021065), and the Domestic Visiting Training Program for Outstanding Young Backbone Teachers (gxgnfx2022035).