Page 104 - Abstract Book KONIKA 18

Allergy Immunology

P-AI-003
Stevens-Johnson Syndrome in a 9-year-old Child: A Rare Case

Agung Danan Jaya, I Gst Agung Ngurah Sugitha Adnyana
Department of Child Health, Mother and Child Hospital Puri Bunda Denpasar, Bali, Indonesia
Abstract
Background Stevens-Johnson syndrome (SJS) is an acute, severe mucosal hypersensitivity reaction that
requires immediate medical intervention. About 74-94% of SJS cases are associated with adverse drug
reactions and responses to infection. In children, SJS is often triggered by infection. More than half of SJS
cases in children develop against a background of upper respiratory tract infection (URTI). Objective To report
a rare incidence of SJS in a 9-year-old child suspected to be caused by infection and drugs.Case A 9-year-old
boy came to emergency room (ER) with chief complaint of swollen and blistered lips accompanied by red
spots on the chest, abdomen, and both hands. The patient had symptoms of upper respiratory tract infection
since 4 days ago, cough, runny nose and fever up to 37.80C. History of medication taken by patient were
paracetamol, pseudoephedrine, dextromethorphan HBr, chlorphenamine maleate, and cefadroxil. Before
admitted to hospital the patient's condition is getting worse with burning sensation in the eyes and oral
cavity, mouth blisters and difficulty swallowing. This patient was admitted with diagnosis of SJS, receiving
methylprednisolone 10 mg every 12 hours intravenously, ranitidine 20 mg every 12 hours intravenously,
mouthwash 3 times a day, vaseline oral gel applied to the lips 3 times a day, nystatin drop 1 ml 3 times a
day. On 6 days, there was clinical improvement and patient discharge from the hospital.Conclusion In
th
this case, SJS occurred allegedly due to a combination of a history of URTI and worsen by drug reactions.
Keywords: Stevens Johnson syndrome; drug reaction; upper respiratory track infection (URTI)

P-AI–004
Erythrodermic Psoriasis in A 14-years-old Girl : A Case Report

Clara Devina, Lily Irsa, Rita Evalina Rusli, Mahrani Lubis
Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia

Abstract
Background Erythrodermic psoriasis is a rare and severe variant of psoriasis in children which mostly
idiopathic, with estimated prevalence of 1-2.25% of psoriatic patients. Clinicians are challenged to diagnose
and manage erythrodermic psoriasis. Objective To report an erythrodermic psoriasis in a-14 years old-girl.
Case A-14 years old-girl referred from Gunung Sitoli District Hospital with diffuse erythematous macules
and scales almost on entire body surface. It was started as pruritic erythematous macules on both forearms
since 4 months ago, and widely spread to the neck, inguinal, abdomen, and limbs accompanied with hair
and weight loss. This was the first case in the family. Physical examination showed alopecia and scaly
erythematous macules all over the body, psoriatic plaques, diffuse desquamation, and exudative lesions.
There were onychodiscoloration and onychodystrophy on her nail fingers and toes. Skin biopsy showed
monroe abscess which strongly interpreted as Erythrodermic Psoriasis. Patient received hidrocortisone
cream, intensive-hydro protect cream, chloramphenicol zalf for cracky areas, and accompanied by saline
compression. For systemic therapy, patient received oral methylprednisolone 1mg/kgBW b.i.d. She also
got treatment for her severe malnutrition. Patient was discharged from hospital after having improvement
clinically. Conclusion Erythrodermic psoriasis is a rare and severe disorder that require comprehensive
management. Therefore, proper diagnosis and treatment can avoid from life-threatening complications.

Keywords: erythrodermic psoriasis; erythema; skin

56 KONIKA XVIII Abstract Book