Two unusual cases of toxic epidermal necrolysis

Australas J Dermatol. 2002 Feb;43(1):35-8. doi: 10.1046/j.1440-0960.2002.00549.x.

Abstract

Two cases of toxic epidermal necrolysis (TEN) are presented. A 27-year-old woman presented with peripherally located targetoid plaques, papules, blisters and lip erosions which began 9 days after 'recreational' use of 'speed' (dexamphetamine and ephedrine) consistent with erythema multiforme major. Three days later she developed widespread lesions with large areas of blistering affecting 40% of body surface area. The diagnosis was revised to TEN. Intravenous cyclosporin led to rapid prevention of new blister formation. A 71-year-old woman, 3 months after commencing amiodarone, developed extensive erythema, blistering and erosions affecting 50% of body surface area, with a maculopapular rash affecting the limbs and extremities consistent with a diagnosis of TEN. She developed septicaemia following bilateral pneumonia with pleural effusions and died 7 days after admission.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Amiodarone / adverse effects*
  • Amiodarone / therapeutic use
  • Biopsy, Needle
  • Cyclosporins / administration & dosage
  • Dextroamphetamine / adverse effects*
  • Dextroamphetamine / therapeutic use
  • Ephedrine / administration & dosage
  • Ephedrine / adverse effects*
  • Fatal Outcome
  • Female
  • Follow-Up Studies
  • Humans
  • Infusions, Intravenous
  • Risk Assessment
  • Severity of Illness Index
  • Stevens-Johnson Syndrome / drug therapy
  • Stevens-Johnson Syndrome / etiology*
  • Stevens-Johnson Syndrome / pathology*
  • Treatment Outcome

Substances

  • Cyclosporins
  • Ephedrine
  • Amiodarone
  • Dextroamphetamine