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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2001, Number 1

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An Med Asoc Med Hosp ABC 2001; 46 (1)

Toxic epidermal necrolysis

Ortiz PJ, Moreno MM, Guadarrama PE, Monroy SS, Soriano AE, Drijansky R, Moreno CC

Language: Spanish
References: 25
Page: 40-46
PDF size: 244.36 Kb.


ABSTRACT

Objective: Present a case report of a patient with toxic epidermal necrolysis induced by phenitoin and make a deep literature review to point out the importance of an early diagnosis and treatment. Place: The American British Cowdray Medical Center, I.A.P., Mexico City. Toxic epidermal necrolysis (TEN) or Lyell’s syndrome is an idiosyncratic disease characterized by a severe, acute and episodic mucocutaneous reaction produced by multiple drugs and that compromises life. This is a case report of a 41 year old female treated with phenitoin for cerebral vascular ischemic disease, 10 weeks before she was admitted to the hospital. She started with malaise, fever, facial edema, generalized rash that covered 90% of the total body surface which rapidly were haemorragic and tender bulae with epidermal denudation and damage to oral, conjunctival and urogenital mucosae. She was in inverted isolation with daily lesion debridation and covering the damaged skin with 0.5% silver nitrate, also parenteral antibiotics and physiotherapy were given. She was discharged 3 weeks later, with no sequel and 90% of the lesion reepitelized. Conclusion: TEN is an acquired bulous disease that can be misdiagnosed. It is of importance to make diagnosis in time, to give multidisciplinary treatment to avoid complications, sequel or dead itself.


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