A case of toxic epidermal necrolysis comorbid with severe burns

Abstract

Background Toxic epidermal necrolysis (TEN) and severe burns both have high mortality rates, but coexistence is extremely rare. The specificity of developing TEN in burn patients is not well understood and its treatment strategy is not established. Case Presentation A 68‐year‐old man was carried to our hospital with severe burns covering 35% of his body surface area. He developed bacteremia during treatment of burns and required antimicrobial therapy. However, erythema appeared on the trunk and upper limbs and rapidly spread to the extremities, leading to a diagnosis of TEN. The rash gradually improved after terminating antimicrobial therapy and administrating of 1,000 mg/day methylprednisolone for 3 days. The rash caused by TEN was confined to non‐burned areas, suggesting that TEN may less likely occur at burn sites. Conclusion It is necessary to pay attention because burn patients can develop TEN concomitantly. Corticosteroids therapy may be effective for TEN even in severe burn patients.

Keywords

• Burn‐site infection
• mesh skin grafting
• steroid‐pulse therapy
• suicide attempt
• toxic epidermal necrolysis