Title: Allopurinol Induced Toxic Epidermal Necrolysis- A Case Report
Authors: Dr Jatin Kumar Jain, Dr Sunil Rana, Dr Sumit Dhamu, Dr Nisarg Patel
DOI: https://dx.doi.org/10.18535/jmscr/v9i11.30
Abstract
Toxic Epidermal Necrolysis (TEN) is as a rare and a life threatening mucocutaneous condition. Drugs are the leading reported cause of TEN, with the risk of a hypersensitivity reaction mainly in the first few weeks of the drug ingestion. There is strong association between TEN and several drugs, including anti-infectives Sulfonamides, allopurinol, carbamazepine, phenobarbital, nevirapine, lamotrigine, phenytoin, and oxicam-non steroidal anti-inflammatory drugs (NSAIDs).TEN is characterized by widespread keratinocyte apoptosis and sloughing of the skin, erosion of the mucous membranes, painful blistering, and severe systemic disturbance. It involves >30% of total body surface area.
We report a case of 38year old female who developed Toxic epidermal necrolysis after consumption of Allopurinol for joint pain and was being evaluated prognostically with the SCORTEN score.
References
- Stern RS, Divito SJ. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Associations, Outcomes, and Pathobiology-Thirty Years of Progress but Still Much to Be Done. J Invest Dermatol 2017; 137:1004.
- Sekula P, Dunant A, Mockenhaupt M, et al. Comprehensive survival analysis of a cohort of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. J Invest Dermatol 2013; 133:1197.
- Ferrandiz-Pulido C, Garcia-Patos V. A review of causes of Stevens-Johnson syndrome and toxic epidermal necrolysis in children. Arch Dis Child 2013; 98:998.
- Roujeau JC. Stevens-Johnson syndrome and toxic epidermal necrolysis are severity variants of the same disease which differs from erythema multiforme. J Dermatol 1997; 24:726.
- Strom BL, Carson JL, Halpern AC, et al. Using a claims database to investigate drug-induced Stevens-Johnson syndrome. Stat Med 1991; 10:565.
- Rosen AC, Balagula Y, Raisch DW, et al. Life-threatening dermatologic adverse events in oncology. Anticancer Drugs 2014; 25:225.
- Tangamornsuksan W, Chaiyakunapruk N, Somkrua R, et al. Relationship between the HLAB* 1502 allele and carbamazepine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis. JAMA Dermatol 2013; 149:1025.
- Guégan S, Bastuji-Garin S, Poszepczynska-Guigné E, et al. Performance of the SCORTEN during the first five days of hospitalization to predict the prognosis of epidermal necrolysis. J Invest Dermatol 2006;126:272.