title: Toxic epidermal necrolysis related to Cisplatin and pemetrexed for metastatic non-small cell lung cancer.
abstract: BACKGROUND
  Toxic epidermal necrolysis (TEN) is an uncommon but life-threatening adverse drug reaction. Pemetrexed is a multitargeted antifolate. It was first used in combination with cisplatin as a front-line treatment for malignant pleural mesothelioma. The same combination is nowadays approved in the first-line setting for locally advanced or metastatic nonsquamous non-small cell lung cancer (NSCLC).
  
  
  METHODS
  We report the case of a 50-year-old man treated for metastatic NSCLC. Within 5 days after administration of the second cycle of cisplatin and pemetrexed, he developed large blisters, which secondarily became hemorrhagic, and mucosal lesions. The characteristic clinical appearance, the histopathological findings, and the clinical course were decisive for the diagnosis of TEN. Treatment with systemic steroids and intravenous antibiotics as well as topical wound treatment led to resolution and improvement of his general condition.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the third case of TEN due to pemetrexed in a patient with NSCLC. Clinicians should be aware of TEN as a rare but potentially fatal disorder requiring hospitalization and multidisciplinary management.
authors.affiliation: Klinik für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin und thorakale Onkologie, Lungenklinik Lostau gGmbH, Lostau, Deutschland.
authors.forename: Katrin
authors.initials: K
authors.lastname: Scheinpflug
authors.forename: Carina
authors.initials: C
authors.lastname: Menzel
authors.forename: Antje
authors.initials: A
authors.lastname: Koch
authors.forename: Christoph
authors.initials: C
authors.lastname: Kahl
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Achenbach
mesh_terms: D000970:Antineoplastic Agents; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000188:drug therapy / Q000556:secondary*; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D005971:Glutamates / Q000009:adverse effects / Q000627:therapeutic use; D006147:Guanine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D002945:Cisplatin