Toxic epidermal necrolysis during therapy with sulphasalazine in a patient with arthritis. Case report
Rachwał-Siek, K.; Ponikowska, M.; Wiland, P.
Wiadomosci Lekarskie 64(4): 283-287
2011
ISSN/ISBN: 0043-5147 PMID: 22533153 Document Number: 650334
Toxic epidermal necrolysis (TEN) is a severe, life-threatening disease appearing after certain drugs, characterized by keratinocyte necrosis, which shows with painful cutaneous and mucosal exfoliation and systemic involvement. TEN mortality rate is between 30% to 70%, so patients need early administration of medical care. We report a case of a 40-year old woman with TEN-like symptoms, who received treatment with sulphasalazine for 3 weeks because of arthritis. Various diagnostic procedures were performed which caused many doubts about diagnosis. In differential diagnosis we thought about: firstly TEN after treatment with sulphasalazine--patient with systemic lupus erythematosus, secondly toxic epidermal necrolisis like lupus erythematosus, finally TEN and LE after treatment with sulpasalazine--patient with rheumatoid arthritis. Final diagnosis needs more investigation and further diagnostic procedures. The patient stays under our control.