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Flores et al. Plast Aesthet Res 2018;5:24 Plastic and
DOI: 10.20517/2347-9264.2018.31 Aesthetic Research

Case Report Open Access

Successful reconstruction of bilateral oral
commissure fusion secondary to Stevens Johnson

syndrome

Shadai Flores , Dino Maglic , Neal Moores , Rayaad Hosein , Faizi Siddiqi , Barbu Gociman 2
2
2
1
2
2
1 University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
2 Plastic and Reconstructive Surgery, Department of Surgery, University of Utah Health Care, Salt Lake City, UT 84132, USA.
Correspondence to: Dr. Shadai Flores, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
E-mail: shadai.floresarce@hsc.utah.edu
How to cite this article: Flores S, Maglic D, Moores N, Hosein R, Siddiqi F, Gociman B. Successful reconstruction of bilateral oral
commissure fusion secondary to Stevens Johnson syndrome. Plast Aesthet Res 2018;5:24.
http://dx.doi.org/10.20517/2347-9264.2018.31

Received: 5 Jun 2018 First Decision: 13 Jul 2018 Revised: 18 Jul 2018 Accepted: 19 Jul 2018 Published: 27 Jul 2018
Science Editor: Raúl González-García Copy Editor: Jun-Yao Li Production Editor: Cai-Hong Wang

Abstract
Stevens Johnson syndrome (SJS) is a rare and often fatal hypersensitivity reaction commonly triggered by drugs which
results in the uncontrolled destruction of keratinocytes with both cutaneous and mucosal involvement. Fusion of the oral
commissures, although reported in burn victims, is a very uncommon complication of SJS. The successful reconstruction
of oral commissures fusion using a modified commissuroplasty technique in a 19-year-old Hispanic female with severe
microstomia secondary to SJS is presented here. Re-establishment of normal speech, oral intake, as well as aesthetic
appearance were achieved.

Keywords: Steven Johnson syndrome, commissuroplasty, microstomia

INTRODUCTION
Stevens Johnson syndrome (SJS) is a type IV hypersensitivity reaction commonly triggered by drugs which
results in the uncontrolled destruction of keratinocytes with both cutaneous and mucosal involvement.
As a rare and often life-threatening disease, SJS has an annual incidence of approximately 1 to 6 cases per
1 million . Reportedly, ophthalmologic complications are among the most severe sequelae of SJS along
[1]
with cutaneous and gastrointestinal manifestations . Fusion of the oral commissures, although commonly
[2]
reported in burn victims, is a very uncommon complication of SJS. Incomplete fusion of the oral commissures
(bands connecting the lateral aspect of upper and lower lips but sparing the very corner of the mouth) in

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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