title: Lyell's Syndrome and Antimalarials: A Case Report and Clinical Review.
abstract: Toxic epidermal necrolysis (TEN) or Lyell's syndrome is a rare, however, life-threatening mucocutaneous disorder with an epidermal detachment of a total body surface area (TBSA) of >30%. It is triggered by an idiosyncratic immune-allergic reaction to a drug, with many possible drugs implicated. Treatment success relies on early diagnosis and withdrawal of suspected/causative drug(s) and supportive care. Clinical evidence for specific therapies is still sparse. It is described a case of Lyell syndrome by sulfonamides for chemoprophylaxis of malaria. The patient presented with an extensive, rapidly evolving skin detachment, which progressed, despite supportive therapy, involving about 80% of TBSA. This led us to initiate a course of immunoglobulin with good clinical response. The aim of this work is to provide a discussion of the case and simultaneously make a practical literature review of TEN.
authors.affiliation: Department of Anesthesiology, Funchal Central Hospital, Madeira, Portugal.
authors.forename: Joana Miranda
authors.initials: JM
authors.lastname: Nunes
authors.affiliation: Department of Plastic Surgery and Burn Unit, North Lisbon Hospital Centre, Lisboa University Medical School, Lisboa, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Santareno
authors.affiliation: Department of Anesthesiology, Pain and Emergency Medicine, North Lisbon Hospital Centre, Lisboa University Medical School, Lisboa, Portugal.
authors.forename: Lina
authors.initials: L
authors.lastname: Guerreiro
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Oncology Portuguese Institute Francisco Gentil, Lisboa, Portugal.
authors.forename: Ana Filipa
authors.initials: AF
authors.lastname: Margalho
keywords: Immunoglobulin; Lyell syndrome; malaria; sulfonamides; toxic epidermal necrolysis