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Stevens-Johnson Syndrome Associated With Herpes Simplex Virus

Harvey E. Golden, MD
Arch Intern Med. 1993;153(11):1396. doi:10.1001/archinte.1993.00410110088014.
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Regarding the article "Herpes Simplex Virus Associated With Recurrent Stevens-Johnson Syndrome" (SJS) by Detjen et al,1 I would like to provide some information about my own experience in preventing herpes simplex-associated SJS and to raise a question.

In the period 1962 through 1966, I had recurrent episodes of SJS of progressive severity, requiring hospitalization on two occasions, each preceded by an episode of herpes simplex labialis that had begun 7 to 10 days before. Because this was before the availability of acyclovir, I began to treat myself with high doses of prednisone about 5 days after my original lip lesion developed, ie, at a time when there was no longer a vesicle, but the beginning of healing.

This strategy prevented recurrent episodes of severe stomatitis and SJS, and if I reduced the dose of prophylactic prednisone too far (from 40 to 20 mg/d for 7 days) I might get


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