Chloroquine-induced toxic epidermal necrolysis

Area of Science:

• Pharmacovigilance
• Tropical Medicine
• Dermatology

Background:

• Malaria remains a significant global health challenge, necessitating effective treatment strategies.
• Chloroquine phosphate is a widely used antimalarial drug, but its safety profile requires continuous monitoring.
• Severe cutaneous adverse drug reactions (SCARs) are rare but potentially fatal complications of medication use.

Purpose of the Study:

• To report two cases of severe adverse drug reactions (Stevens-Johnson syndrome and toxic epidermal necrolysis) in malaria patients treated with chloroquine phosphate.
• To emphasize the importance of recognizing and managing these rare but life-threatening reactions.
• To contribute to the understanding of chloroquine-induced dermatological toxicity.

Main Methods:

• Case report of two female patients diagnosed with malaria.
• Documentation of treatment regimen, including daily intramuscular injections of chloroquine phosphate for three days.
• Clinical observation and progression of adverse events, including Stevens-Johnson syndrome and toxic epidermal necrolysis.

Main Results:

• Both patients presented with symptoms consistent with Stevens-Johnson syndrome after chloroquine phosphate administration.
• The condition rapidly progressed to toxic epidermal necrolysis in both cases.
• Despite intensive medical care, both patients unfortunately succumbed to the severe drug reactions.

Conclusions:

• Chloroquine phosphate, particularly when administered intramuscularly, can be associated with severe and potentially fatal cutaneous adverse drug reactions.
• Early recognition and prompt management are crucial for SCARs, although outcomes can be poor.
• This case series underscores the need for vigilance regarding chloroquine's safety, especially in vulnerable populations or when administered via specific routes.