Severe Cutaneous Reaction Induced by Clindamycin: A Case Report of Toxic Epidermal Necrolysis

Toxic epidermal necrolysis (TEN) is a rare, acute inflammatory skin reaction that results in skin blistering and extensive epidermal detachment. Stevens-Johnson syndrome (SJS) and TEN are unified aspects on a spectrum varying in the severity of vesiculobullous cutaneous eruptions with mucosal involvement of the oral cavity, genitourinary tract, gastrointestinal tract, and conjunctiva. The inciting event is usually caused by an exaggerated hypersensitivity reaction in response to triggering medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, urate-lowering drugs (such as allopurinol), anticonvulsants, and antipsychotics. We report a case of clindamycin-induced TEN in a 79-year-old African-American female following the recent administration of clindamycin for a developing sacral decubitus ulcer. However, lincosamide antibiotics like clindamycin are rarely associated with precipitating SJS or TEN. This report highlights the treatment and prognostic challenges faced throughout the patient's clinical course and seeks to highlight the importance of recognizing the development of SJS/TEN following novel drug administration and promptly addressing the management of the condition to improve long-term patient outcomes.