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]