Stevens-Johnson syndrome (SJS) is one of the most severe cutaneous eruptions occurring in children. The standard of care for treatment of patients with SJS is supportive. Off-label use of intravenous immunoglobulin (IVIG) has been used for treatment of many autoimmune and bullous diseases, including SJS,1 and is thought to have a relatively safe adverse effect profile. Serious adverse effects include anaphylaxis (in patients with IgA deficiency), renal tubular necrosis (in patients with renal insufficiency or dehydration), and aseptic meningitis. Minor adverse events occurring in approximately 10% of patients include headache, myalgia, chest discomfort, and fever.2 Adverse skin reactions occur rarely and include urticaria, pruritus, petechiae, alopecia, and leukocytoclastic vasculitis. In addition, vesicular eczema (a pompholyxlike eruption) has been reported in patients after therapy with IVIG for treatment of neurologic disease.3 We report a case of a pompholyxlike eruption occurring in a patient treated with IVIG for SJS. We hope to highlight this important association because the development of new vesicular lesions in such patients may be cause for concern about reactivation or progression of the primary skin disease.
Vesicular eczema after intravenous immunoglobulin therapy for Stevens-Johnson syndrome occurring on the palmar aspects of the hands of a 7-year-old girl.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Dermatology editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 10
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Users' Guides to the Medical Literature
For example, a trial of intravenous immunoglobulin in advanced human immunodeficiency infection...
All results at
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.