Toxic epidermal necrolysis in a patient affected by mixed essential cryoglobulinemia

A patient with mixed essential cryoglobulinemia and polysystemic involvement developed cutaneous lesions characterized by erythematopurpuric maculae and blisters over his entire body. Such lesions appeared during the course of treatment with prednisone and cyclophosphamide when penicillin was added to the therapeutic regimen. The diagnosis of drug-related toxic epidermal necrolysis was made on the basis of clinical history and histologic features. The possible relationship with the underlying immunologic aberration and the active immunosuppression is discussed.