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Concurrent Gastrointestinal Perforation and Cardiopulmonary Arrest in Toxic Epidermal Necrolysis: A Case of Profound
Sheikha Alketbi1,2, Amani Abdulla AlFalasi1,2, Alia Galadari1,2
1Dermatology, Rashid Hospital, Dubai Health, Dubai, ARE.
Abstract:
Toxic epidermal necrolysis (TEN) is a serious, life-threatening cutaneous adverse reaction whose prevalence is widespread epidermal necrosis and detachment, mostly initiated by an adverse drug reaction. Muco-cutaneous manifestation is well-known, but severe systemic complications, specifically gastrointestinal complications and cardiac events, are extremely uncommon, with few cases reported in the literature. This case describes a 27-year-old man who was diagnosed with TEN after taking ibuprofen. He had colonic perforation and cardiopulmonary arrest despite systemic therapies and a multidisciplinary approach. The case study shows that even though TEN is associated with poor prognosis, there are rare serious complications, which are likely to be mediated in this case by the excessive systemic inflammatory response and coagulopathy due to sepsis, and have detrimental outcomes. These unusual complications must be detected early and dealt with aggressively to enhance patient survival in severe TEN.
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