Sulindac-lnduced Stevens-Johnson Toxic Epidermal Necrolysis Syndrome

DURING the past few years, a number of nonsteroidal, nonsalicylate, anti-inflammatory drugs have been introduced; the newest of these is sulindac.1With any newly introduced medication, uncommon but potentially serious side effects may not become evident until the drug has been used by a large number of persons. We observed a patient who had a blistering, erosive, potentially lethal cutaneous reaction that was probably induced by sulindac. Report of a Case A 39-year-old nurse in a petrochemical plant who was in excellent health suffered a painful traumatic injury to her right shoulder after slipping on ice. She was treated with sulindac, 400 mg/day. On the 15th day of sulindac therapy, she noted a pruritic, macular, erythematous eruption on her chest. During the following 24 hours, the eruption became generalized over the skin and spread to the oral mucosa and vulva. Coincident with the eruption, shaking chills and pyrexia to