Potential Adverse Effect Steven Johnson Syndrome with Supplemental Berberine Use

Christian Hailey Summa^1, , Scarlett Somarriba², Laura Ziton³ and Michelle Demory Beckler⁴

¹PGY-1 Geisinger Northeast Medical Center

²PGY-1 Lower Bucks

³Family Medicine, Coral Springs

⁴Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University

Cite this paper

Christian Hailey Summa, Scarlett Somarriba, Laura Ziton and Michelle Demory Beckler. Potential Adverse Effect Steven Johnson Syndrome with Supplemental Berberine Use. American Journal of Medical Case Reports. 2022; 10(8):199-201. doi: 10.12691/AJMCR-10-8-6

Abstract

Steven-Johnson Syndrome is a rare adverse skin reaction, which may progress to critical conditions. The presentation of SJS is a widespread, type-IV hypersensitivity, skin reaction typically induced by infection and numerous medications which occurs approximately 12 hours after exposure to infection or medication. Patients typically initially present with fever, headache, and general malaise. In these patients, within 4 days to 4 weeks [1] of causative medication usage, a diffuse rash develops. Severe cases of SJS can place the patient in critical condition. Complications of SJS can include bacterial infection, excessive fluid loss from denuded skin (or loss of epidermis), hypovolemic shock, or septic shock. [1] Prompt diagnosis and immediate discontinuation of medication is essential to prevent life threatening complications. Herein, we document a case of a patient presenting to the Emergency Department (ED) three days prior to follow up in our office with bilateral leg rash for which the ED prescribed hydrocortisone cream. Upon examination in office, the erythematous eruption had spread to the entire body including her palms. She had started the herbal supplement berberine a month prior to the initial presentation of the rash. Upon cessation of the berberine and completion of a Medrol dose pack, the rash resolved.

Keywords

Steven- johnson syndrome, rash, Berberine, supplements, adverse effects, exposure

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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