A patient with HIV presents with both fever and significant skin complications after starting allopurinol. What condition does this likely represent?

The scenario described likely indicates Stevens-Johnson syndrome (SJS), a serious skin reaction that can occur in patients who have been prescribed certain medications like allopurinol, especially in individuals with underlying conditions such as HIV. SJS is characterized by the development of flu-like symptoms—such as fever—and extensive skin detachment and mucous membrane involvement, which can be particularly alarming and life-threatening.

In patients with HIV, the risk of developing severe drug reactions like SJS is heightened due to a compromised immune system, making this reaction even more problematic. Allopurinol is known to be a common culprit in inducing SJS, especially in those with predisposing factors. The acute onset of symptoms following medication initiation supports this diagnosis.

Other conditions listed may have overlapping symptoms, such as allergic dermatitis, which typically involves localized rashes and does not usually present with widespread skin involvement or systemic symptoms. Contact urticaria is usually a transient and localized reaction that does not align with the severe presentation described. Systemic lupus erythematosus is an autoimmune condition that can cause various systemic issues, but it is not typically linked inherently to allopurinol nor presents in the same acute manner as SJS.

Thus, when evaluating the significant fever and