Single Dose of Etanercept Injection: A Game Changer in Toxic Epidermal Necrolysis: A Case Series

Abstract

Toxic Epidermal Necrolysis (TEN) is a rare hypersensitivity reaction to drugs, characterised by widespread erythema, full-thickness epidermal necrosis with mucosal involvement, and extensive apoptosis. It is a dermatological emergency and can be lethal if not promptly treated. The use of steroids in managing TEN is controversial since no gold standard therapy exists. However, a single dose of subcutaneous injection of Etanercept (a Tumour Necrosis Factor-alpha (TNF-α) inhibitor) at a dosage of 50 mg has shown promise in preventing mortality and reducing hospital stay. The authors present a case series of six TEN patients, out of which three received a single dose of Etanercept injection. All patients who received Etanercept showed a positive response, achieving complete re-epithelialisation with a median healing time of nine days. In conclusion, injection of Etanercept, a TNF-α inhibitor, effectively inhibits Fas-Fas ligand activation, thus preventing apoptosis and extensive necrosis.

Keywords

• adverse drug reaction
• apoptosis
• re-epithelialisation
• tumor necrosis factor-α inhibitors