Chronic pulmonary complications associated with toxic epidermal necrolysis: A case report and literature review

Abstract

Patients with toxic epidermal necrolysis (TEN) are known to experience various complications. Although pulmonary complications are commonly observed, they typically manifest in an acute form. By contrast, chronic complications are quite rare, and little is known with regard to their incidences or clinical manifestations. The present study reports the case of a 29-year-old female patient who suffered from TEN. At the onset of the disease, the patient exhibited no pulmonary impairment; however, 1 month after recovering from TEN, the patient developed severe obstruction and a mild diffusion defect. A diagnosis of bronchiolitis obliterans was determined, and the patient was treated with antibiotics, inhaled corticosteroids, anticholinergic agents, and bronchodilators. At the last follow-up, the patient was alive, but with a stable airway obstruction.

Keywords: chronic pulmonary complications; toxic epidermal necrolysis.

Figure 1.

(A) Chest high-resolution computed tomography scan and (B) chest X-ray conducted following recovery from toxic epidermal necrolysis.

Figure 2.

(A) Inspiratory CT scan demonstrating mosaic attenuation at the upper lobes of the two lungs. An area of decreased attenuation in the right lobe is demarcated by the gray arrow. (B) Expiratory CT, performed at approximately the same level as the inspiratory image. The area of decreased attenuation in the right lobe remained lucent on expiration (gray arrow). CT, computed tomography.

Figure 3.

Results of lung function tests of the patient following the development of chronic pulmonary complications. FEV1, forced expiratory volume in 1 sec; FVC, forced vital capacity; Pre, predicted.