title: Toxic epidermal necrolysis in patient with malignant astrocytoma.
abstract: Toxic epidermal necrolysis (TEN) is a severe, life-threatening mucocutaneus adverse reaction, most commonly triggered by medication. Treatment in some aspects is still controversial.
  
  
  METHODS
  Patient with malignant astrocytoma, treated with palliative radiotherapy, developed massive erythema with bullae. Patient suffered from tumor-related epilepsy, treated pharmacologically with carbamazepine. After dermatological consultation TEN was diagnosed. The bacterial growth tests from blood were Staphylococci positive. An antibiotic therapy was performed and carbamazepine was withdrawn. Cyclosporine was administered. After 2 weeks of treatment, skin changes vanished and patient's condition improved. TEN could not be omitted in diagnosis of extensive skin changes because the causative drug removal is crucial for survival and pharmacological treatment varies in similar conditions. TEN as a drug-related disease more likely occurs in severely ill patients.
authors.affiliation: Medical University of Warsaw, Warsaw, Poland: Chair and Department of Internal Medicine and Endocrinology.
authors.forename: Dorota
authors.initials: D
authors.lastname: Kaczmarska-Turek
authors.affiliation: Medical University of Warsaw, Warsaw, Poland: Chair and Department of Internal Medicine and Endocrinology.
authors.forename: Paweł
authors.initials: P
authors.lastname: Bartnik
authors.affiliation: Medical University of Warsaw, Warsaw, Poland: Chair and Department of Internal Medicine and Endocrinology.
authors.forename: Joanna
authors.initials: J
authors.lastname: Kacperczyk
authors.affiliation: Medical University of Warsaw, Warsaw, Poland: Chair and Department of Internal Medicine and Endocrinology.
authors.forename: Jan
authors.initials: J
authors.lastname: Orlewski
authors.affiliation: Medical University of Warsaw, Warsaw, Poland: Chair and Department of Dermatology.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Olszewska
authors.affiliation: Medical University of Warsaw, Warsaw, Poland: Chair and Department of Internal Medicine and Endocrinology.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Krasnodębska-Kiljańska
mesh_terms: D001254:Astrocytoma / Q000532:radiotherapy*; D001425:Bacterial Outer Membrane Proteins; D001932:Brain Neoplasms / Q000532:radiotherapy*; D002220:Carbamazepine / Q000009:adverse effects* / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D011878:Radiotherapy / Q000009:adverse effects*; D012867:Skin / Q000473:pathology*; D013262:Stevens-Johnson Syndrome / Q000209:etiology*
chemical_list: D001425:Bacterial Outer Membrane Proteins; C071990:FatA protein, bacteria; D002220:Carbamazepine
keywords: astrocytoma; carbamazepine; toxic epidermal necrolysis