{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T23:43:29Z","timestamp":1789688609835,"version":"4.0.1"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,28]],"date-time":"2024-07-28T00:00:00Z","timestamp":1722124800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,28]],"date-time":"2024-07-28T00:00:00Z","timestamp":1722124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Stevens\u2013Johnson syndrome-toxic epidermal necrolysis\u00a0(SJS-TNE) overlap is a rare skin disorder characterized by erythema, blisters, extensive exfoliation, epidermal detachment, the involvement of multiple mucosae, and positive Nikolsky\u2019s sign. SJS-TEN has a high mortality rate. Our case involves a rare occurrence of drug-induced Stevens\u2013Johnson syndrome-toxic epidermal necrolysis overlap with a delayed onset in the setting of quetiapine and famotidine therapy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>An 82-year-old Taiwanese female was admitted to our hospital for decreased urine output, generalized edema, and multiple skin blisters and bedsores. With further spread of the lesions, multiple ruptured bullae with shallow erosions on the face, trunk, and limbs and mucosal involvement affected 20% of the total body surface area. Nikolsky\u2019s sign was positive. A diagnosis of Steven\u2013Johnson syndrome was highly suspected. One month prior, she had started famotidine and quetiapine. Intravenous methylprednisolone treatment was initiated, which ameliorated the skin lesions after 3\u00a0days. However, new lesions developed after only 1\u00a0day of methylprednisolone tapering. The patient died 12\u00a0days after admission.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Stevens\u2013Johnson syndrome-toxic epidermal necrolysis is a rare skin disorder. Although it is mainly acute and has a high mortality rate, delayed onset can still occur. Quetiapine and famotidine are generally safe and effective for treating geriatric and gastrointestinal problems, but rare drug hypersensitivity reactions can lead to debilitating consequences. Therefore, increased clinical awareness and the initiation of supportive care are imperative. Optimal management guidelines are still lacking, and confirmation of developed guidelines through randomized controlled trials is needed. Collaboration for better management strategies is warranted.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04629-6","type":"journal-article","created":{"date-parts":[[2024,7,28]],"date-time":"2024-07-28T00:03:43Z","timestamp":1722125023000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Stevens\u2013Johnson syndrome-toxic epidermal necrolysis overlap in a patient taking quetiapine and famotidine: a case report"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2916-8187","authenticated-orcid":false,"given":"Chi-Sheng","family":"Su","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Lan","family":"Kao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,28]]},"reference":[{"key":"4629_CR1","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1001\/archderm.1993.01680220104023","volume":"129","author":"S Bastuji-Garin","year":"1993","unstructured":"Bastuji-Garin S, Rzany B, Stern RS, Shear NH, Naldi L, Roujeau J-C. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. Arch Dermatol\u00a0[Internet]. 1993;129:92\u20136.","journal-title":"Arch Dermatol\u00a0[Internet]"},{"key":"4629_CR2","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1016\/j.jid.2016.03.023","volume":"136","author":"DY Hsu","year":"2016","unstructured":"Hsu DY, Brieva J, Silverberg NB, Silverberg JI. Morbidity and mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis in United States adults. J Investig Dermatol. 2016;136:1387\u201397.","journal-title":"J Investig Dermatol"},{"key":"4629_CR3","doi-asserted-by":"publisher","first-page":"1600","DOI":"10.1056\/NEJM199512143332404","volume":"333","author":"J-C Roujeau","year":"1995","unstructured":"Roujeau J-C, Kelly JP, Naldi L, Rzany B, Stern RS, Anderson T, et\u00a0al. Medication use and the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis. 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Accessed 5 May 2022."}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04629-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-024-04629-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04629-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,28]],"date-time":"2024-07-28T00:03:54Z","timestamp":1722125034000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-024-04629-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,28]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4629"],"URL":"https:\/\/doi.org\/10.1186\/s13256-024-04629-6","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,28]]},"assertion":[{"value":"24 May 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed written consent was obtained from the patient. All specific identifying information regarding the patient was deidentified. This case report did not include any new or experimental treatment; hence, approval from an ethics committee was not needed. However, approval from our ethics committee was obtained.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient\u2019s next of kin for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"344"}}