Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis and Treatment With a Biologic: A Case Report

Abstract

Introduction: One of the most dangerous dermatologic emergencies is Stevens-Johnson Syndrome (SJS)/toxic epidermal necrolysis (TEN). Although a rare disease, it can often lead to significant mortality.

Case presentation: In this case report, we present a 77-year-old man who developed a sloughing rash that was secondary to a nonsteroidal anti-inflammatory drug. In addition to the recommended supportive care, the patient was treated with etanercept, a new, less commonly used intervention.

Discussion: We provide a brief review of SJS/TEN. Nonsteroidal anti-inflammatory drugs are a rare cause of SJS/TEN, and additionally, the use of biologics is a novel treatment modality for SJS/TEN.

Figure 1

Patient’s left forearm showing sloughing of skin. Patient had a positive Nikolsky sign.

Figure 2

Patient’s neck showing sloughing of skin.

Figure 3

Patient’s right wrist is dusky but without sloughing.

Figure 4

Timeline of the case. Derm = Dermatology Department; ED = Emergency Department; IM = Internal Medicine IV = intravenous; PO = orally; R = right; SJS = Stevens-Johnson Syndrome; TEN = toxic epidermal necrolysis.

Figure 5

Severity of illness score called SCORTEN (SCORe of Toxic Epidermal Necrolysis).