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Case Reports
. 2024 Dec 23:11:1522525.
doi: 10.3389/fmed.2024.1522525. eCollection 2024.

Case report: Toxic epidermal necrolysis induced by tislelizumab in a patient with esophageal squamous cell carcinoma

Shilong Wu  1 , Chenyang Xu  1 , Huafeng Liu  2
Affiliations
Case Reports

Case report: Toxic epidermal necrolysis induced by tislelizumab in a patient with esophageal squamous cell carcinoma

Shilong Wu et al. Front Med (Lausanne). .

Abstract

Background: Immune checkpoint inhibitors (ICIs) have been widely applicated for the treatment of patients with advanced esophageal cancer. Skin-related adverse reactions are frequent with ICIs, with toxic epidermal necrolysis (TEN) being a severe and potentially life-threatening cutaneous reaction.

Case presentation: We present a case of a 70-year-old male with locally advanced esophageal cancer who developed severe toxic epidermal necrolysis (TEN) after 18 days of tislelizumab combined with chemotherapy. The condition rapidly progressed to cover approximately 90% of his body. After treatment with intravenous methylprednisolone, immunoglobulin, and antibiotics, along with active nutritional support and wound care, the patient recovered from TEN induced by tislelizumab.

Conclusion: Treatment for TEN is complex, and no standardized guidelines currently exist. We propose an economical, safe, effective, and simple strategy for similar TEN patients.

Keywords: esophageal squamous cell carcinoma; immune-related adverse events; skin toxicity; tislelizumab; toxic epidermal necrolysis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Chest computed tomography (A) and endoscopic ultrasonography (B) showed esophageal squamous cell carcinoma in the mid-chest area.
Figure 2
Figure 2
Tislelizumab-related skin toxicity. (A) Oral mucositis; (B) Rashes of the trunk; (C) Blisters; (D) Toxic epidermal necrolysis.
Figure 3
Figure 3
Wound care for toxic epidermal necrolysis (A). An image of the skin after recovery from toxic epidermal necrolysis (B).
Figure 4
Figure 4
Schematic representation of the patient’s treatment history.
See this image and copyright information in PMC

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