title: [Lethal Lyell's syndrome induced by fusidic acid].
abstract: BACKGROUND
  Herein, we report the first case of toxic epidermal necrosis due to oral fusidic acid having a fatal outcome.
  
  
  METHODS
  An 82-year-old woman was referred to our dermatology department for generalized bullous skin eruption. Clinical examination showed fever, oral and ocular ulcerations, and epidermal detachment involving more than 70 % of her body surface area together with a positive Nikolsky sign. Lyell's syndrome was diagnosed. Cutaneous histology showed total epidermal necrosis and a normal dermis. Oral fusidic acid had been prescribed 12 days earlier for a chronic sacral pressure sore. No other treatment had been introduced during the previous two months. The outcome was fatal within 24 hours.
  
  
  CONCLUSIONS
  Fusidic acid is commonly used topically by dermatologists for limited staphylococcal skin infections. Oral treatment is rare and is recommended only for skin, bone or joint infections. This is the first reported case of toxic epidermal necrolysis due to oral fusidic acid. The French national drug safety monitoring register contains only one case in which fusidic acid was a possible culprit.
  
  
  CONCLUSIONS
  Fusidic acid must be considered a potential source of serious cutaneous adverse reactions, particularly toxic epidermal necrolysis.
authors.affiliation: Clinique universitaire de dermatologie, allergologie et photobiologie, CHU de Grenoble, boulevard de la Chantourne, CS10217, 38043 Grenoble cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Cluzel
authors.affiliation: Clinique universitaire de dermatologie, allergologie et photobiologie, CHU de Grenoble, boulevard de la Chantourne, CS10217, 38043 Grenoble cedex 9, France. Electronic address: ppralong@chu-grenoble.fr.
authors.forename: P
authors.initials: P
authors.lastname: Pralong
authors.affiliation: Centre régional de pharmacovigilance, CHU de Grenoble, boulevard de la Chantourne, CS10217, 38043 Grenoble cedex 9, France.
authors.forename: S
authors.initials: S
authors.lastname: Logerot
authors.affiliation: Clinique universitaire de dermatologie, allergologie et photobiologie, CHU de Grenoble, boulevard de la Chantourne, CS10217, 38043 Grenoble cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Sabatier-Vincent
authors.affiliation: Clinique universitaire de dermatologie, allergologie et photobiologie, CHU de Grenoble, boulevard de la Chantourne, CS10217, 38043 Grenoble cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Tardieu
authors.affiliation: Service d'anatomo-pathologie, CHU de Grenoble, boulevard de la Chantourne, CS10217, 38043 Grenoble cedex 9, France.
authors.forename: N
authors.initials: N
authors.lastname: Pinel
authors.affiliation: Clinique universitaire de dermatologie, allergologie et photobiologie, CHU de Grenoble, boulevard de la Chantourne, CS10217, 38043 Grenoble cedex 9, France.
authors.forename: M-T
authors.initials: MT
authors.lastname: Leccia
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017809:Fatal Outcome; D005260:Female; D005672:Fusidic Acid / Q000009:adverse effects*; D006801:Humans; D013262:Stevens-Johnson Syndrome / Q000209:etiology*
chemical_list: D000900:Anti-Bacterial Agents; D005672:Fusidic Acid
keywords: Acide fusidique; Fusidic acid; Lyell's syndrome; Nécrolyse épidermique toxique; Severe allergic drug eruption; Syndrome de Lyell; Toxic epidermal necrolysis; Toxidermie sévère