Necrólisis epidérmica tóxica: Reporte de caso

Abstract

Introduction: This case report describes a severe presentation of toxic epidermal necrolysis (TEN) in a 27-year-old female patient, triggered by the use of lamotrigine. TEN is a rare and potentially life-threatening immunological reaction that affects the skin and mucous membranes. This clinical case highlights the importance of recognizing early symptoms and prompt management to improve the prognosis. Clinical manifestations: The patient presented with erythematous lesions that evolved into painful blisters and extensive skin desquamation, as well as ocular involvement with a foreign-body sensation, oral and genital mucosal involvement, and respiratory symptoms requiring intensive care. Diagnosis: The diagnosis was confirmed based on medication history, clinical presentation, and evaluation with the SCORTEN scale, which estimated a mortality of 35.5%. Treatment: Discontinuation of the causative agent, management of complications, and administration of glucocorticoids and intravenous immunoglobulins were included, which progressively improved the skin lesions in conjunction with multidisciplinary management, achieving stabilization of respiratory and hemodynamic function. The patient was discharged after 9 days of hospitalization. This case highlights the need for timely diagnosis and management to prevent severe complications of TEN, emphasizing the effectiveness of the combination of glucocorticoids and immunoglobulins. Conclusion: Early identification of TEN and rapid initiation of immunomodulatory treatment can reduce complications and improve clinical outcomes in severe cases.