Two unusual cases of toxic epidermal necrolysis.
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.
Yung
Anthony
A
Dermatology Unit, Greenlane Hospital, Auckland, New Zealand. ants_ange@hotmail.com
Agnew
Karen
K
Snow
John
J
Oliver
Fergus
F
D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000009:adverse effects* / Q000627:therapeutic use; D001707:Biopsy, Needle; D003524:Cyclosporins / Q000008:administration & dosage; D003913:Dextroamphetamine / Q000009:adverse effects* / Q000627:therapeutic use; D004809:Ephedrine / Q000008:administration & dosage / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D018570:Risk Assessment; D012720:Severity of Illness Index; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology*; D016896:Treatment Outcome
D003524:Cyclosporins; D004809:Ephedrine; D000638:Amiodarone; D003913:Dextroamphetamine