Successful Treatment of Toxic Epidermal Necrolysis More Than 70% Body Surface Area Involved with Immunosuppressive Therapy and Amniotic Membrane Graft in Cornea

Abstract

A 19 years young boy presented with papulo-vesicular lesions with necrosis over face, trunk upper and lower extremities; erosions and ulcerations over mucous membrane of eyes, mouth and genetalia. Lesions involved more than 70% of body surface area. Medical history was significant that was taking carbamazepine for epilepsy. On histopathological examination lymphatic infiltration at the dermoeidermal junction (DEJ) with necrosis of keratinocytes that some areas in full thickness. Management done in Enam Medical College Hospital (EMCH) in general ward with correction of fluid and electrolyte imbalance. Systemic steroid used in immunosuppressive dose and patient epidermal regrowth occur within 22-24 days. Main problem at that time gradual loss of vision, recurrent corneal erosion syndrome and tear film deficiency. Ophthalmology department of EMCH done amniotic membrane graft dry eye and corneal erosion.

DOI: 10.3329/medtoday.v22i1.5608

Medicine Today Vol.22(1) 2010. 50-52