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Case of Steven-Johnson Syndrome in a male with breast cancer secondary to docetaxel/cyclophosphamide therapy
  1. Benjamin Jarrett1,
  2. Sehem Ghazala1,
  3. Joseph Chao2,
  4. Sachin Chaudhary3
  1. 1Department of Internal Medicine, University of Arizona, Tucson, Arizona, USA
  2. 2Department of Dermatology, University of Arizona, Tucson, Arizona, USA
  3. 3Department of Pulmonary and Critical Care, University of Arizona, Tucson, Arizona, USA
  1. Correspondence to Dr Benjamin Jarrett, bjarrett{at}


The mortality rate for Stevens-Johnson syndrome (SJS) is estimated to be ∼12% and for toxic epidermal necrolysis (TEN) it is around 30%. It continues to be a severe life-threatening drug reaction. We present a 60-year-old Caucasian man with a medical history significant for breast cancer status post mastectomy and chemotherapy with docetaxel and cyclophosphamide who presented with severe mucositis and a progressing skin rash consistent with SJS. He was started on high-dose corticosteroids and IVIG but continued to have worsening mucosal ulcerations and severe bleeding from the oral, conjunctival and genital mucosa. He underwent several rounds of plasmapheresis and additional high-dose steroids with mild improvement in the mucocutaneous manifestations. He subsequently developed respiratory failure, which required mechanical ventilation, as well as disseminated intravascular coagulation, diffuse alveolar haemorrhage, with Pneumocystis jirovecii pneumonia which led to his demise on hospital day 15.

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  • Contributors BJ: wrote the case discussion and learning points; SG: Wrote the case hospital course and investigations; JC: discussed dermatology findings and differential diagnosis; SC: case management and supervised the writing of this case.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.