Abstract
Introduction:Toxic epidermal necrolysis(TEN)is a medical emergency that most commonly occurs as an adverse effect of certain drugs.Here,we describe a case of a 41-year-old man with no comorbid illness who developed TEN.Case presentation:The patient had been prescribed ibuprofen for myalgia and developed skin lesions after the single dose.The lesions were erythematous papules and macules distributed all over the body after ibuprofen intake.TEN was diagnosed based on the patient's clinical presentation and laboratory findings.He was treated with intravenous dexamethasone,intravenous immunoglobulin,and cyclosporine.Daily dressing changes and skin care was done with saline,chlorhexidine,and liquid paraffin.The patient was intubated and tracheostomized,and he gradually improved and survived.Later,he developed septicemia in the intensive care unit and was treated successfully.Discussion:The management of TEN includes cessation of the causative cause,multidisciplinary intensive care unit(ICU)care,prevention and early detection of sepsis,fluid and electrolyte balance,adequate analgesia and temperature control,proper organ support,aggressive nutritional management,and good psychological support.The pharmacological therapy for TEN includes corticosteroids,intravenous immunoglobulin,and cyclosporine.The key elements of management are aseptic care and proper dressing of the skin.Conclusion:TEN is associated with high mortality if not managed in a systemic and protocolized way.
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