Toxic epidermal necrolysis induced by COVID-19
Accepted: 12 November 2023
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Toxic epidermal necrolysis (TEN) is a life-threatening acute mucocutaneous syndrome. It is characterized by keratinocyte necrosis and apoptosis, which affect more than 30% of the body's surface. TEN is most commonly due to an altered immunological response to specific drugs, infections, and malignancies, or it can be idiopathic. The combination of TEN and COVID-19 can have a fatal outcome if not recognized and promptly treated. Therefore, fast reporting of such cases will draw doctors’ attention to quick and right intervention. In this article, we present a 66-year-old patient with a clinical presentation of toxic epidermal necrolysis along with a coexisting COVID-19 infection. To our knowledge, this is the first case of TEN in a patient diagnosed with SARS CoV‑2 infection in Saudi Arabia.
Sekula P, Dunant A, Mockenhaupt M, et al. Comprehensive survival analysis of a cohort of patients with Stevens–Johnson syndrome and toxic epidermal necrolysis. J Invest Dermatol. 2013; 133(5): pp. 1197–1204. DOI: https://doi.org/10.1038/jid.2012.510
Yang M-S, Lee JY, Kim J, Kim G-W, Kim B-K, Kim J-Y, et al. Incidence of Stevens-Johnson syndrome and toxic epidermal necrolysis: A nationwide population-based study using National Health Insurance Database in Korea [Internet]. PloS one. Public Library of Science; 2016 [cited 27 Jun 2022]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5106005/#!po=12.5000
Alajaji A, Chandra Shekaran J, Mohammed Aldhabbah O, Alhindi HA, Almazyad NS, Aljutayli ZA, et al. Toxic epidermal necrolysis (TEN)/Stevens-Johnson syndrome (SJS) epidemiology and mortality rate at King Fahad Specialist Hospital (KFSH) in Qassim region of Saudi Arabia: A retrospective study [Internet]. Dermatology Research and Practice. Hindawi; 2020 [cited 27 June 2022]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568810/ DOI: https://doi.org/10.1155/2020/7524726
Labib A, Milroy C. Toxic epidermal necrolysis [Internet]. Ncbi.nlm.nih.gov. 2022 [cited 27 June 2022]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK574530/
Saha M. Toxic epidermal necrolysis and co-existent SARS-CoV-2 (COVID-19) treated with intravenous immunoglobulin: ‘Killing 2 birds with one stone’ [Internet]. En.x-mol.com. 2022 [cited 21 July 2022]. Available from: https://en.x-mol.com/paper/article/1295772431962218496
Emadi S-N, Hamzelou S, Saffarian Z, & Shakoei S. (2021, January). Challenges in the treatment of a patient with toxic epidermal necrolysis associated with Covid-19: A case report. Dermatologic Therapy. Retrieved 27 June 2022 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883031/ DOI: https://doi.org/10.1111/dth.14656
Jouhar L, Yahya M, Elsiddiq S. Toxic epidermal necrolysis associated with COVID-19 infection: A case report. Clin Case Reports. 2022 Mar;10(3). DOI: https://doi.org/10.1002/ccr3.5565
Narang I, Panthagani AP, Lewis M, Chohan B, Ferguson A, Nambi R. Covid-19-induced toxic epidermal necrolysis [Internet]. Clinical and experimental dermatology. U.S. National Library of Medicine; [cited 27 June 2022]. Available from: https://pubmed.ncbi.nlm.nih.gov/33511662/ DOI: https://doi.org/10.1111/ced.14574
Rossi CM, Beretta FN, Traverso G, Mancarella S, Zenoni D. A case report of toxic epidermal necrolysis (TEN) in a patient with COVID-19 treated with hydroxychloroquine: Are these two partners in crime. Clin Mol Allergy. 2020 Oct 6;18(1). DOI: https://doi.org/10.1186/s12948-020-00133-6
Aulakh S, Arora R, Sarangal R, Chopra D. Increased predisposition of SJS TEN in COVID-19 patients, presenting as post COVID complication: Report of two cases. Indian Dermatol Online J. 2022 Jan 1;13(2):237–9. DOI: https://doi.org/10.4103/idoj.idoj_510_21
Zou H, Daveluy S. Toxic epidermal necrolysis and Stevens-Johnson syndrome after COVID-19 infection and vaccination. Australas J Dermatol. 2023 Feb;64(1):e1-e10. doi: 10.1111/ajd.13958. Epub 2022 Dec 9. PMID: 36484649; PMCID: PMC9878214 DOI: https://doi.org/10.1111/ajd.13958
Copyright (c) 2024 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.