Management of toxic epidermal necrolysis in an adult patient: Challenges and their management during COVID-19 pandemic

• Main Authors: Ragunatha Shivanna (Author), Gaurav Ramakrishna (Author), Godwin K Mannur (Author)
• Format: Book
• Published: Wolters Kluwer Medknow Publications, 2021-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2542-551X; 2542-5528; 10.4103/cdr.cdr_125_20
• Keywords: acute skin failure; covid-19; cyclosporine; toxic epidermal necrolysis; Dermatology; RL1-803
• Source: Clinical Dermatology Review, Vol 5, Iss 1, Pp 30-33 (2021)

An adult male patient who underwent neurosurgery for extradural hematoma following road traffic accident presented with toxic epidermal necrolysis (TEN) secondary to phenytoin. The patient was semiconscious and not responding to verbal commands. The patient was admitted and managed with oral cyclosporine and supportive measures. TEN is a dermatological emergency presenting as acute skin failure. The management requires multidisciplinary approach in an intensive care setup. The treatment includes the administration of immunosuppressant drugs and maintenance of hemodynamic stability. However, the COVID-19 pandemic has resulted in a lot of limitations regarding the use of immunosuppressant drugs and in-patient care because of the possibility of transmission of COVID-19 infection among patients, their caretakers and health-care professionals. Here, we are presenting a case of TEN managed successfully during the pandemic of COVID-19. Strict adherence to all the guidelines recommended by concerned authorities related to the prevention of transmission of COVID-19 and judicious use of immunosuppressant drugs based on risk and benefit ratio is very crucial.