He was living with his wife and his elementary-age son. He was running a small barbershop, which was popular among the neighbors, with his wife in a shopping mall located in an old town. One day, he had listlessness in his body and took a cold medicine in the medicine cabinet. Then, he…

He first started to feel something unusual on Saturday morning. He had listlessness in his body but thought that he could not take a day off. So, he took a cold medicine he had bought for future use. The cold medicine had not passed its expiration date, and he took it according to the predetermined dose and usage. His fever suddenly got higher when he was about to call it a day that evening. His wife told him that he had red eyes. He casually looked at his hands and feet and found red rash on them. He finished his work earlier than usual and went to bed. However, he had rash in larger numbers on the following day instead of getting better. He measured his body temperature, which was higher than 39 degrees Celsius.

He was always reluctant to visit a hospital but visited an emergency hospital with encouragement from his family. He was asked if he had taken any drugs and was told by the doctor that he might be experiencing Stevens-Johnson syndrome due to a side effect of the drug. He was urgently carried to a general hospital in an ambulance. On his way to the general hospital, he lost his consciousness and fell critically ill. He was on the verge of life and death. Fortunately, he survived and regained his consciousness about a week later. He was examined by an ophthalmologist at the general hospital after regaining his consciousness. Because of his bad eye condition, he was transferred to a university hospital.

A year later, he recovered from the skin signs and symptoms. However, he still had decreased visual acuity in his left eye and could not read letters with it. He could read only large-print letters on a newspaper with his right eye. He had dryness in his eyes, which made it impossible for him to keep his eyes open for a while. Although he had been running a barbershop, he became unable to use scissors or razors and closed his barbershop. In such a situation, he told us that he was grateful for his survival, wanted to run a barbershop again for his family supporting him and would do his best with a high expectation of medical advances.

Doctor's Comment

Eighty percent (80%) of patients with Stevens-Johnson syndrome with serious eye condition have “cold-like symptoms” such as listlessness in the whole body and sore throat before experiencing a high fever and rash.

When the systemic condition is serious, eye treatment will be postponed. Even in such a case, ophthalmologists may be able to alleviate eye sequelae if they are involved in diagnosis and treatment from the beginning.

Other Case: R. Y. (then-22-year-old woman)