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A 28 year old male presented with rash on his arms, legs and face, and painful ulceration of his lips and mouth along with fever. He developed an acute sore throat and conjunctivitis, following which a diagnosis of acute pharyngitis was made, presumed streptococcal, and oral penicillin was prescribed. All of the following can be used in the treatment of the above disease except: -

A
Cyclophosphamide
B
IVIg
C
Cyclosporine
D
Etanercept
High-Yield Explanation
This is a case of Steven Johnson syndrome with the classical targetoid lesions. In Stevens- Johnson syndrome, lesions involve not only the skin but also the lips and oral mucosa, conjunctiva, urethra, and genital and perianal areas. On histologic examination, the "targetoid" lesions show a superficial perivascular, lymphocytic infiltrate associated with dermal edema and accumulation of lymphocytes. These are along the dermo-epidermal junction, where they are intimately associated with degenerating and necrotic keratinocytes, a pattern termed interface dermatitis. Treatment approved are: - Steroids IVIg Cyclosporine Etanercept

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