Case report of a patient with toxic epidermal necrolysis with complications and review of literature

Introduction Toxic epidermal necrolysis (TEN), also known as Lyell’s syndrome, is a rare exfoliative disorder with a high mortality rate. This entity was first described by Lyell in 1956, who termed the condition ‘toxic epidermal necrolysis,’ pointing out that drug sensitization was generally considered to be the mechanism leading to this syndrome. The drugs most frequently involved are nonsteroidal anti-inflammatory drugs (NSAID), chemotherapeutic agents, antibiotics, and anticonvulsants, although viral, bacterial, and fungal infections, as well as immunization, have been described. Case outline We present a 72-year-old man with the following history. Five days before he was admitted, the patient had high fiver and sore throat. He was treated with antibiotics and NSAID because he had bronchopneumonia, after which he developed itchy skin rash all over his body, followed by the sensation of slight sore throat, with conjunctival hyperemia and hard breathing and high fiver, due to which he was hospitalized in the local hospital. After worsening of the symptoms, followed by urticaria-like plaques and bullae with progress all over the body, the patient was moved to our institution and placed in the Intensive Care Unit, under suspicion of TEN. The aim of the paper presented here is to give a thorough summary of our literature review searching for the best therapy modalities for our patient with TEN. Conclusion Our standpoint is that TEN patients with multiorgan system lesions, with 80% of the total body surface area affected, and with SCORTEN scale score of 4 can be successfully treated if diagnosed early.