Ibuprofen Unveiled: A Middle-Aged Odyssey through
Stevens-Johnson
Syndrome
Ahmed Qasim Mohammed Alhatemi1, Hashim Talib Hashim2, Mohammed Abdul
Rahman 3, Rand K Abdulhussain 4. Ali Talib Hashim5.
- Al Nasiriyah Teaching Hospital, Thi Qar, Iraq.dr.ahmedqasim95@gmail.com
- Warith Al Anbiyaa university, Karbala, Iraq.hashim.talib@uowa.edu.iq
- Al Nasiriyah Teaching Hospital, Thi Qar, Iraq.m.shyea95@gmail.com
- University of Huddersfield, Huddersfield, UK.randkabdulhussain@gmail.com
- Golestan University of medical sciences, Gorgan, Iran.talibhashim42@gmail.com
*Corresponding Author: Ali Talib Hashim, Golestan University of
medical sciences, Gorgan,Iran.talibhashim42@gmail.comConsent statement: Written informed consent was obtained from
the patient to publish this report in accordance with the journal’s
patient consent policy
We declare that we have no conflict of interest
No source of funding receive
Data availability statement The data that support the findings
of this study are available from
the corresponding author upon reasonable request.
Clinical key message
Ibuprofen, a common NSAID, may unravel unexpected dangers like
Stevens-Johnson Syndrome. This case underscores the urgency of
recognizing adverse drug reactions, urging vigilance in both healthcare
and public spheres for safer medication practices.Introduction:Ibuprofen, a widely used nonsteroidal anti-inflammatory drug (NSAID),
has long been a stalwart in the realm of pain relief and inflammation
management. However, behind its commonplace presence in medicine
cabinets, there lies a potential peril that, though rare, demands our
attention and understanding. This narrative unfolds as a middle-aged
individual embarks on an unexpected journey through the harrowing
landscape of Stevens-Johnson Syndrome (SJS) – a severe and, at times,
life-threatening skin disorder (1,2).
As the story begins, it beckons us to consider the seemingly innocuous
act of reaching for an over-the-counter pain reliever. In this case,
ibuprofen serves as the unwitting protagonist, a common choice for those
grappling with the discomforts of everyday ailments (3). The
unsuspecting middle-aged protagonist, seeking respite from a routine
headache or muscular ache, unwittingly triggers a chain of events that
will unfold into a rare and alarming medical ordeal (4).
Stevens-Johnson Syndrome, characterized by the abrupt onset of a painful
rash and blistering, often involves the mucous membranes, including the
eyes, nose, and mouth. It can be triggered by various medications, and
ibuprofen, despite its ubiquity and perceived safety, is not exempt from
this list (5). The narrative explores the unfolding symptoms, the
perplexing escalation from mild discomfort to severe skin involvement,
and the subsequent medical odyssey that ensues (5).
This exploration delves into the broader implications of drug safety,
shedding light on the delicate balance between the benefits and risks of
widely used medications. It underscores the importance of vigilance,
both on the part of healthcare providers and the public, in recognizing
potential adverse reactions (6). Through this journey, we navigate the
intricacies of drug-induced skin disorders and the critical role of
prompt medical intervention in steering the narrative towards recovery
(7). ”Ibuprofen Unveiled” invites readers to contemplate the uncharted
territories that can emerge from seemingly routine decisions and prompts
a reconsideration of our relationship with common medications that weave
seamlessly into the fabric of our daily lives.KeywordsAcute medicine, Dermatology, Immunology, Critical care medicine,
pharmacology and
pharmacy.
Case presentation
A middle-aged female presented to the emergency room with a sudden onset
of severe facial swelling, red painful eyes with discharge, crusting and
erosion of lips, and a generalized non-blanching purpuric rash,
predominantly on the chest, upper, and lower limbs.
Upon thorough history-taking, it was revealed that she had taken
ibuprofen for flu-like symptoms three days prior. She had no past
medical history of chronic diseases and was not taking any medications.
She is a non-smoker and non-drinker.
During examination, the patient, an average-built female, appeared in
distress but was fully conscious, oriented to time, place, and person.
Cardiac, respiratory, and neurological examinations were unremarkable.
Her vital signs were as follows: BP 133/88 mmHg, RR 22, SpO2 95%, HR 88
bpm, and a temperature of 38.4°C.
Head, neck, and eye examination revealed conjunctivitis with discharge,
coalescing deep red erythematous targeted macules with central blister
formation on the face, and swelling, erosion, and yellowish discharge of
the lips (chelitis) as depicted in figure 1.