[Acute onset Hodgkin's disease following Lyell's syndrome]

In most cases, toxic epidermal necrolysis is a drug-induced reaction. Other causes such as lymphomas have also been suspected. We report herein a new association of toxic epidermal necrolysis and Hodgkin's disease in a male patient.

A 62-year-old man consulted for erythroderma, scalded skin and mucous erosions involving the oral, nasal and genital areas. Nikolsky's sign was present. Cutaneous biopsy confirmed the diagnosis of toxic epidermal necrolysis. Our patient acknowledged intake of fexofenadine 48 hours before the eruption. He also developed enlarged lymph nodes whose histopathological examination revealed Hodgkin's disease. Exploration of cytolytic hepatitis disclosed replicating chronic viral B hepatitis. The skin disorder quickly improved and our patient underwent CHOP chemotherapy.

Association of toxic epidermal necrolysis and lymphoproliferative disorders has been reported. Development of toxic epidermal necrolysis is normally related to administration of antineoplastic drugs. However, lymphomas may be diagnosed after the onset of toxic epidermal necrolysis in the absence of drug intake, pointing to a possible aetiological role of haematological disease in the development of toxic epidermal necrolysis.