Successful Management of a 31-Year-Old Woman with Toxic Epidermal Necrolysis

Abstract

Toxic epidermal necrolysis (TEN) is a rare but life-threatening mucocutaneous reaction most commonly induced by medications. Early recognition and multidisciplinary supportive care are pivotal to reduce morbidity and mortality. A 31-year-old woman presented with widespread erythematous scaly patches and flaccid bullae involving approximately 62% body surface area, with oral and ocular mucosal involvement, four days after receiving multiple oral medications post-cesarean section. Laboratory workup revealed hypoalbuminemia, anemia, hyperkalemia, and acute kidney injury. SCORTEN at admission was 2. Management included withdrawal of suspected drugs, systemic corticosteroid (IV methylprednisolone), aggressive fluid and wound care (NaCl wet dressing, Cutimed Sorbact coverage), topical antimicrobials, ophthalmic care including autologous serum eye drops, and multidisciplinary consultations. The patient improved and was discharged after 23 days. In conclusions, early recognition and evidence-based multidisciplinary management are crucial to optimizing outcomes in TEN.