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CASE REPORT
Year : 2017  |  Volume : 9  |  Issue : 1  |  Page : 23-30

Lyell's syndrome and antimalarials: A case report and clinical review


1 Department of Anesthesiology, Funchal Central Hospital, Madeira, Portugal
2 Department of Plastic Surgery and Burn Unit, North Lisbon Hospital Centre, Lisboa University Medical School, Lisboa, Portugal
3 Department of Anesthesiology, Pain and Emergency Medicine, North Lisbon Hospital Centre, Lisboa University Medical School, Lisboa, Portugal
4 Department of Plastic, Reconstructive and Aesthetic Surgery, Oncology Portuguese Institute Francisco Gentil, Lisboa, Portugal

Correspondence Address:
Joana Miranda Nunes
Pain and Emergency Medicine, Funchal's Central Hospital, Avenida Luis de Camões, n°57 – 9004-514 Funchal
Portugal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-777X.199994

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Toxic epidermal necrolysis (TEN) or Lyell's syndrome is a rare, however, life-threatening mucocutaneous disorder with an epidermal detachment of a total body surface area (TBSA) of >30%. It is triggered by an idiosyncratic immune-allergic reaction to a drug, with many possible drugs implicated. Treatment success relies on early diagnosis and withdrawal of suspected/causative drug(s) and supportive care. Clinical evidence for specific therapies is still sparse. It is described a case of Lyell syndrome by sulfonamides for chemoprophylaxis of malaria. The patient presented with an extensive, rapidly evolving skin detachment, which progressed, despite supportive therapy, involving about 80% of TBSA. This led us to initiate a course of immunoglobulin with good clinical response. The aim of this work is to provide a discussion of the case and simultaneously make a practical literature review of TEN.


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2008 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow
Online since 10th December, 2008