Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Stevens-Johnson syndrome is an uncommon inflammatory skin disorder in which immune mechanisms, cytotoxic reactions, and delayed hypersensitivity seem to be involved. Herein, an unusual case with strange complaint of “bus allergy” is presented, suffering from severe generalized itching and skin lesions, followed by ulcers in his mouth and genitalia. The diagnosis of Stevens-Johnson syndrome was made and appropriate treatment was advised. However, detailed medical history revealed a completely different cause of his allergic reactions, as he had occasionally used dimenhydrinate because of motion sickness in his history. Therefore, adverse drug reaction to dimenhydrinate was considered as the main underlying cause of the disease. In conclusion, thorough medical history should be taken to make a definitive diagnosis and identify the underlying disease, since accurate diagnosis and appropriate treatment can prevent further complications.Stevens-Johnsonov sindrom je rijetka upalna bolest kože gdje se pretpostavlja da su uključeni imuni mehanizmi, citotoksične reakcije i odgođena preosjetljivost. Ovdje se prikazuje neuobičajen slučaj čudne “alergije na autobus” u bolesnika s teškim generaliziranim svrbežom i oštećenjima kože, nakon čega su nastali ulkusi u njegovim ustima i genitalijama. Kod bolesnika je dijagnosticiran Stevens-Johnsonov sindrom i preporučeno je odgovarajuće liječenje. Međutim, podrobna anamneza otkrila je potpuno drugi uzrok njegovih alergijskih reakcija, jer je povremeno uzimao dimenhidrat zbog bolesti pokreta u anamnezi. Stoga je zaključeno da je štetna reakcija na dimenhidrat bila glavni osnovni uzrok bolesti. Postavljanje konačne dijagnoze i utvrđivanje osnovne bolesti zahtijeva podrobno uzimanje anamneze, jer točna dijagnoza i primjereno liječenje mogu spriječiti daljnje komplikacije
