Methotrexate-Induced Stevens–Johnson Syndrome

Introduction: Stevens–Johnson Syndrome (SJS) is a rare but serious medical condition characterized by severe skin reactions and mucosal damage, potentially triggered by certain medications, including methotrexate.

Background: Methotrexate is widely used to treat autoimmune diseases, inflammatory conditions, and certain cancers. Although uncommon, methotrexate-associated SJS can cause severe complications and may be life-threatening.

Study Objective: To systematically review and evaluate the clinical characteristics, risk factors, severity, and outcomes of methotrexate-induced Stevens–Johnson syndrome.

Clinical Manifestations: Examine symptoms such as fever, skin rashes, blistering, skin peeling, painful lesions, and inflammation of the eyes, mouth, and other mucosal surfaces.

Risk Factors: Identify potential risk factors, including medication dosage errors, impaired kidney function, drug interactions, underlying medical conditions, and individual susceptibility.

Diagnosis and Assessment: Evaluate diagnostic approaches, including clinical examination, medication history, skin assessment, laboratory investigations, and skin biopsy when required.

Treatment Approaches: Review management strategies, including immediate discontinuation of methotrexate, supportive care, fluid and electrolyte management, wound care, pain control, and specialist-directed treatments.

Clinical Outcomes: Assess disease severity, recovery time, complications, hospitalization duration, mortality, and long-term effects.

Comparative Analysis: Compare reported cases based on patient demographics, methotrexate dosage, treatment duration, clinical presentation, disease severity, and recovery outcomes.

Challenges and Limitations: Examine difficulties in early diagnosis, distinguishing SJS from other severe skin reactions, limited case reports, underreporting, and variations in treatment approaches.

Conclusion: Understanding methotrexate-induced Stevens–Johnson syndrome is essential for early recognition, prompt drug withdrawal, and appropriate clinical management to reduce complications and improve patient outcomes.