Toxic epidermal necrolysis associated with high intake of sildenafil and its response to infliximab

Sir, Toxic epidermal necrolysis (TEN) is a rare, but wellknown acute and life-threatening disorder first described by Lyell (1). It is defined as epidermolytic necrosis induced most commonly by drugs (1, 2). If the loss of epidermis exceeds 30%, it is called TEN, whereas less than 30% skin affection is called either Stevens-Johnson (SJ) syndrome (v10%) or intermediate SJ-TEN (10– 30%). It can involve the internal surfaces of the gastrointestinal tract (1, 2). We describe here a classical case of TEN induced by poly-pharmacy including the intake of aphrodiasic herbal drugs and sildenafil. Treatment with infliximab led to a rapid recovery.