Carvedilol Induced Toxic Epidermal Necrolysis: A Rare Case Report

Abstract

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe, life threatening immunologically mediated, mucocutaneous, Adverse Drug Reactions (ADR) associated with high mortality which requires immediate medical care. Carvedilol is a non selective adrenergic blocker used for the therapy of heart failure with hypertension and left ventricular dysfunction following Myocardial Infarction (MI) in clinically stable patients. Hereby, authors report of a 69-year-old male, with a history of MI and hypertension, who received Carvedilol at a dose of 75 mg daily and four days after the first dose of carvedilol, patient presented with erythematous maculopapular rash on face, trunk and limbs with fever up to 38°C. Skin biopsy from one of the fresh lesions showed apoptotic keratinoctyes, subepidermal cleft and monocytic infiltrate in the dermis and the findings were compatible with the diagnosis of TEN. Early recognition and cessation of the drug is of prime importance along with apt treatment and supportive care.

Keywords

• adrenergic blocker
• steven johnson syndrome
• type iv hypersensitivity