title: The Phytotherapeutic Fenugreek as Trigger of Toxic Epidermal Necrolysis.
abstract: We describe the case of a 32-year-old woman who presented to the hospital with generalized painful exanthema, blisters and erosions 1 month after giving birth to a healthy girl. The patient's medical history was inconspicuous for comorbidities; however, it included the incidental intake of pain killers and a herbal preparation (fenugreek), which she took regularly over the last 4 weeks to improve lactation. Based on the clinical characteristics, we suspected toxic epidermal necrolysis (TEN), a severe cutaneous adverse drug reaction, which was confirmed by skin biopsy. The patient was treated with high-dose intravenous human immunoglobulins and was discharged 2 weeks after hospital admission in good condition. The allergological workup identified fenugreek as the most likely causative agent. Given the increased self-medication of freely available phytotherapeutics by patients in industrialized countries, herbal mixtures should be taken into consideration in the diagnostic workup of TEN.
authors.affiliation: Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Bentele-Jaberg
authors.forename: Emmanuella
authors.initials: E
authors.lastname: Guenova
authors.forename: Tarun
authors.initials: T
authors.lastname: Mehra
authors.forename: Mirjam
authors.initials: M
authors.lastname: Nägeli
authors.forename: Yung-Tsan
authors.initials: YT
authors.lastname: Chang
authors.forename: Antonio
authors.initials: A
authors.lastname: Cozzio
authors.forename: Lars E
authors.initials: LE
authors.lastname: French
authors.forename: Wolfram
authors.initials: W
authors.lastname: Hoetzenecker
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D028321:Plant Preparations / Q000009:adverse effects*; D013262:Stevens-Johnson Syndrome / Q000209:etiology* / Q000473:pathology; D029910:Trigonella / Q000009:adverse effects*
chemical_list: D028321:Plant Preparations