Pabani Umesh Kumar, Khan Zahid, Ali Layla, Shah Shuheda K, Khan Jebriel Ali
Internal Medicine, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR.
Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR.
Cureus. 2023 Sep 6;15(9):e44812. doi: 10.7759/cureus.44812. eCollection 2023 Sep.
Toxic epidermal necrolysis (TEN) is a life-threatening, blistering dermatitis. It is characterized by fever and the development of mucocutaneous lesions, which lead to necrosis and sloughing of the epidermis. It is commonly triggered by medications and infections. We present the case of a 75-year-old male who presented to the hospital with a fever and widespread exfoliating skin rash involving 41% of his body surface area (BSA). He has a past medical history of gout, hypertension, asthma, and depression. He was recently started on allopurinol by his general practitioner (GP) for hyperuricemia. The condition also involved oral, eye, and pharynx mucosae. He was diagnosed with toxic epidermal necrolysis and was managed with intravenous (IV) hydrocortisone, steroid and antibiotic eye drops, and steroid and antibiotic topical creams. Due to the weak available evidence supporting the use of ciclosporin and intravenous immunoglobulins, this patient was managed with steroid use only. His rash initially worsened, but ultimately, he made a full recovery without any sequelae. The patient was reviewed in the dermatology clinic four weeks post-discharge, and he did not have any residual disease.
中毒性表皮坏死松解症（TEN）是一种危及生命的水疱性皮炎。其特征为发热以及黏膜皮肤损害的出现，这些损害会导致表皮坏死和脱落。它通常由药物和感染引发。我们报告一例75岁男性病例，该患者因发热和广泛的剥脱性皮炎入院，累及体表面积（BSA）的41%。他既往有痛风、高血压、哮喘和抑郁症病史。他的全科医生（GP）近期因高尿酸血症开始给他使用别嘌醇。病情还累及口腔、眼睛和咽部黏膜。他被诊断为中毒性表皮坏死松解症，并接受了静脉注射氢化可的松、类固醇和抗生素眼药水以及类固醇和抗生素外用乳膏治疗。由于支持使用环孢素和静脉注射免疫球蛋白的现有证据不足，该患者仅接受了类固醇治疗。他的皮疹最初有所加重，但最终完全康复，未留下任何后遗症。患者出院四周后在皮肤科门诊接受复查，未发现任何残留疾病。
