Stevens-Johnson syndrome following measles vaccination.

Erythema Multiforme (EM) is specific acute hypersensitivity syndrome of multiple etiologies. It has distinct clinical pattern the hallmark of which, is the erythematous rash (so called iris or target lesions). Although a single type of lesion may predominate during a particular attack, the basic lesion of erythema multiforme are macular, urticarial and vesicobullous. The diagnosis of Erythema multiforme is climcal. Steven Johnson Syndrome (SJS) is considered as an extremely severe form of erythema multiforme with high fever, prostration, constitutional symptoms and widespread bullae which involve most of the cutaneous surfaces and mucous membranes of the conjunctivae, mouth, flares, anorectal junction, vulvovaginal region and urethral meatus. By definition involvement of skin and atleast two mucous membranes constitute the diagnosis of SJS. But new insights, especially the histopathology, are compelling many to recognize this syndrome as being distinct from EM. Various etiological agents have been implicated in the causation of SJS. Association of syndrome with ingestion of drugs, including sulfonamides, penicillin, anticonvulsants and barbiturates, has been observed. Infectious agents, especially viruses have been thought to cause the syndrome. Steven Johnson Syndrome has been reported in association with Hepatitis B vaccination. We report a case of severe SJS following measles vaccination in a child, an association as yet unreported in literature.