Rodríguez SO, Pérez AT, Espinosa RD, Gómez DAR, Peinado MR

Language: Spanish
References: 5
Page:
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ABSTRACT

Introduction: Toxic epidermal necrolysis is an acute, rare process with high morbidity and mortality, characterized by necrosis and detachment of the epidermis in large cutaneous areas. Its etiology is mainly due to an abnormal immune reaction to different drugs against keratinocytes. The most significant clinical findings are maculopapular lesions that evolve to vesicles, affecting mainly the oral and conjunctival mucosas, as well as the genital area, but can affect the whole body including palms and soles, involving more than 30% of the body surface. Objective: To describe the behavior of toxic epidermal necrolysis secondary to allopurinol use. Case presentation: A 47-year-old male patient with a history of being treated with Allopurinol was presented. After four days, he started with palpebral edema, phlyctenas on his face, macular erythematous lesions disseminated on his neck, thorax and the inguinoscrotal region, as well as erythematous-ulcerous lesions that reached 37 % of total body surface. Conclusions: The patient developed a nontraumatic acute cutaneous failure syndrome due to toxic epidermal necrolysis associated with the allopurinol use. He responded satisfactorily to the applied therapy despite the multiple complications suffered during his evolution.

REFERENCES

1. Mayorga JS, Jiménez AV, Sánchez AC. Síndrome de Stevens-Johnson y Necrólisis Epidérmica Tóxica, un reto diagnóstico y terapéutico. Rev Med Sinergia. 2020;5(1): 308.

2. Frey N, Jossi J, Bodmer M, Bircher A, Jick SS, Meier CR. The Epidemiology of Stevens Johnson Syndrome and Toxic Epidermal Necrolysis in the UK. J Invest Dermatol. 2017;6;137(6):1240-7. DOI: https://doi.org/10.1016/j.jid.2017.01.031

3. Hasegawa A, Abe R. Recent advances in managing and understanding Stevens-Johnson syndrome and toxic epidermal necrolysis. F1000Res. 2020;9:F1000. DOI: https://doi.org/10.12688/f1000research.24748.1

4. Arora R, Pande RK, Panwar S, Gupta V. Drug-related Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Review. Indian J Crit Care Med. 2021;25(5):575-9. DOI: https://doi.org/10.5005/jp-journals-10071-23826

5. Ueta M. Pathogenesis of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis with Severe Ocular Complications. Front Med (Lausanne). 2021;8:651247. DOI: https://doi.org/10.3389/fmed.2021.651247