A Case of Trichloroethylene Hypersensitivity Syndrome

A 36-year-old Chinese man presented with a 6-day history of fever, a 5-day history of a generalized erythematous maculopapular rash, a 4-day history of red sore eyes, and a 3-day history of sore lips. He did not have any history of ingestion of medications or herbs. Physical examination revealed a generalized erythematous maculopapular rash, which gradually became confluent and dusky, but was still blanchable. No blisters were seen at presentation. There were extensive moist erosions on the patient’s lips, buccal mucosa, and oropharynx. There was bilateral conjunctival injection, which the ophthalmologist diagnosed as pseudomembranous conjunctivitis. There was no hepatosplenomegaly. Histologic examination of the patient’s skin showed subepidermal clefting and bulla formation, with necrotic keratinocytes in the middle and lower epidermis. Vacuolar degeneration was evident in the basal layer, and there was an infiltrate of lymphocytes in the upper dermis and perivascular area. These findings were reported to be consistent with erythema multiforme (Figure 1).