Severe Skin Disease Gets Fresh Attention Amid Worries Over Painkiller Side

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The Wall Street Journal


Severe Skin Disease Gets Fresh Attention Amid Worries Over Painkiller Side Effects

By HEATHER WON TESORIERO
February 8, 2005; Page D1

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Jane Webb, age 64, took Vioxx for years to help quell arthritis pain in her hands. In July, her doctor switched her to Bextra, another Cox-2 painkiller, to see if it would give her greater relief. A week into taking the new drug, the retired physics professor from Newport News, Va., noticed red blotches on her arms. She hadn't been told of any possible skin reactions, but was worried enough to see her dermatologist. The doctor diagnosed Stevens Johnson Syndrome, a rare illness most commonly triggered by medications. By the next day, the entire surface of her body was covered with blotches, welts and pimple-like bumps. "They were on my face, in my hair, in my ear," Mrs. Webb says.

In the long list of drug side effects to worry about, skin reactions may rank low compared with deadlier problems like heart attack and stroke. But even rare conditions are very real and can be serious. In severe cases, SJS, which attacks the skin and mucous membranes, can result in blindness or death.

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In theory, SJS can result from any drugs. But drugs containing sulfa, such as the antibiotic Bactrim; nonsteroidal anti-inflammatory medications such as Cox-2 inhibitors and ibuprofen; anticonvulsives such as Dilantin; and antigout drugs including Allopurinol, have been the most frequently implicated in SJS. In children, the disease has also been associated with a bacterial infection.

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Classic SJS symptoms include lesions on mucous membranes and itchy, painful sores and blotches elsewhere on the skin, which typically set in within a week of taking a drug. Doctors say that early detection and intervention can lessen symptoms and improve the prognosis.

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