Carbamazepine-Induced Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Overlap With Severe Ocular and Oral Involvement: A Pediatric Case Report From Uganda.

We report a case of carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) overlap in an 11-year-old Ugandan boy who presented with fever, facial swelling, ocular redness with photophobia, painful oral ulceration, and widespread epidermal detachment involving more than 10% of the body surface area. Symptoms developed 10 days after initiation of carbamazepine for newly diagnosed epilepsy. Examination revealed extensive mucocutaneous involvement characterized by bilateral eyelid edema, conjunctival inflammation, perioral hemorrhagic crusting, erosive oral ulcers, and a positive Nikolsky sign. A clinical diagnosis of carbamazepine-induced SJS/TEN overlap was established based on the temporal relationship to drug exposure and characteristic clinical findings. Immediate withdrawal of carbamazepine and multidisciplinary supportive care resulted in marked clinical improvement. This case highlights the importance of early recognition, prompt withdrawal of the offending drug, and multidisciplinary supportive care in improving outcomes for pediatric SJS/TEN, particularly in resource-limited settings.