A patient develops severe, life-threatening blistering with fever and conjunctivitis after starting a drug; most consistent with

• A. Erythema multiforme
• B. Stevens-Johnson Syndrome
• C. Pemphigus vulgaris
• D. Urticaria

Answer: (B)

Severe mucocutaneous reaction triggered by a medication, with fever and involvement of the eyes, is Stevens-Johnson Syndrome. This condition features widespread blistering and necrosis of the epidermis with mucous membrane involvement, including the conjunctiva, and it often follows drug exposure. Its seriousness and the combination of skin detachment and mucosal inflammation distinguish it from other blistering conditions.

Erythema multiforme can have mucosal involvement but is typically less extensive and often presents with targetoid skin lesions rather than widespread epidermal necrolysis. Pemphigus vulgaris is an autoimmune blistering disease with mucosal erosions and a positive Nikolsky sign, but it doesn’t classically present with an acute drug-triggered onset accompanied by fever and the same pattern of widespread blistering. Urticaria presents as pruritic wheals without deep, widespread blistering or mucosal involvement. The described scenario best fits Stevens-Johnson Syndrome.