Case
A 57 – year- old male patient who had been diagnosed with Covid-19 on
21 st of December 2020,was consulted from Emergency Department to
Dermatology department. He presented with painful erosions in the oral
mucosa and anogenital area. [Figure 1] He was asymptomatic
for Covid- 19 and was under treatment favipiravir.
We got a 4mm punch biopsy with ‘Steven Johnson Syndrome (SJS)’ and
generalized bullous drug eruption as the initial diagnosis. In the
biopsy specimen; subepidermal blistering due to marked epidermal
necrosis was reported. Dermis and epidermis were distincly dissociated.
There were fibrin and mixed inflammatory cells located in the
subepidermal cleft. [Figure 2] The dermis was infiltrated
with moderate cell infiltration, mostly with eosinophils and vascular
proliferation.
The biopsy was consistent with SJS. Together with the clinical and
histopathological findings, the patients was diagnosed as SJS. The
patient was treated with 60 mg intramuscular methylprednisolone for 3
days and topical silver sulfadiazin twice a day. In addition, the
patient applied wet dressing 5 times a day with 0.1% Rivanol solution.
After 1 -week-treatment period, the patient almost completely got
healed. [Figure 3]