Severe TEN Management in a Patient with Schizophrenia

2017 
Background: Toxic epidermal necrolysis (TEN) is a rare and severe dermatologic reaction that could be life- threatening. Typically, it is related to or caused by various medicines that are most commonly antiepileptic. Secondary to epidermolysis, the skin and mucous membranes can also be involved. Severe burn injuries can be associated with acute kidney injury, sepsis, and respiratory dysfunction; however, regardless of severity, early diagnosis and proper treatment can improve the outcome. Case Presentation: Here, we report a case of TEN that led to AKI, loss of conciseness, and respiratory failure in a patient with schizophrenia who had a good outcome despite the severity of the mentioned problems. Rigorous treatment included intensive fluid therapy, intravenous immunoglobulin, and wound coverage with a synthetic cover (silver) after gentle early debridement. Conclusions: This case report revealed that appropriate hydration, intravenous immunoglobulin, and high dose corticosteroid plus intensive wound care might be necessary to treat and improve outcomes in patients who suffer from severe TEN.
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