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A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
Published on: March 14, 2025
Tranexamic acid-induced toxic epidermal necrolysis.
Maider Pretel Irazabal1, Laura Marques Martin, Leyre Aguado Gil
1Department of Dermatology, School of Medicine, University Clinic of Navarra, Pamplona, Spain. mpretel@unav.es
The Annals of Pharmacotherapy
|March 1, 2013
Summary
This case report details toxic epidermal necrolysis (TEN), a severe skin reaction, caused by oral tranexamic acid in a patient with liver cirrhosis. This highlights a rare but serious adverse effect of tranexamic acid.
Area of Science:
- Dermatology
- Pharmacology
- Internal Medicine
Background:
- Toxic epidermal necrolysis (TEN) is a rare, severe mucocutaneous adverse reaction with high mortality.
- Understanding drug-induced TEN is crucial for patient safety and public health.
- Tranexamic acid is commonly used for bleeding but potential severe adverse reactions require investigation.
Observation:
- A 67-year-old male with liver cirrhosis and rectal bleeding was treated with oral tranexamic acid.
- The patient developed a progressive rash, blisters, and epidermal necrosis, consistent with TEN.
- Skin biopsy confirmed TEN, and the patient unfortunately died due to complications.
Findings:
- This case suggests a probable link between oral tranexamic acid and the development of TEN.
- This is the first documented case of TEN induced by oral tranexamic acid.
- The Naranjo probability scale indicated a probable relationship between tranexamic acid and TEN.
Implications:
- Clinicians should be aware of the potential for severe cutaneous adverse reactions, including TEN, with oral tranexamic acid.
- This case underscores the importance of monitoring for adverse drug reactions, especially in patients with underlying conditions.
- Further research may be needed to elucidate the mechanisms of tranexamic acid-induced TEN.
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