Case Report: Toxic epidermal necrolysis: a rare pediatric case report from Nepal

Abstract

Toxic epidermal necrolysis (TEN) is a life-threatening cutaneous reaction to various medications like antibiotics and antiepileptics characterized by erythematous rashes, diffuse necrosis, and exfoliation of skin and mucous membranes, with a high mortality rate. Here, we present a case of six years old female child from Nepal who presented with fever and rashes, was diagnosed with measles and treated with cefixime, ibuprofen, and other drugs. Six hours after taking the drugs, the child developed generalized rashes, blisters formation, and peeling of the skin which progressed to cover most of the skin of her body within the next two days. She was then diagnosed with TEN and admitted to the Pediatric Intensive Care Unit (PICU) and treated by a multidisciplinary team with antibiotics, systemic steroids, antihistamines, wound care, and other medications. The child's fever subsided and her skin and oral lesions gradually regenerated. She was discharged after twelve days of hospitalization as she improved clinically and symptomatically. TEN is a dermatological emergency that should be diagnosed and treated promptly to minimize the fatal outcome of the disease.