Multidisciplinary management of antiepileptic drug-induced toxic epidermal necrolysis in a young woman

Abstract

Toxic epidermal necrolysis is a rare, life-threatening dermatological emergency characterized by extensive epidermal detachment and mucosal involvement,  associated with high morbidity and mortality. Early  diagnosis and prompt treatment are imperative to improving patient outcomes. This case report describes the clinical course, management, and outcomes of a 29-year-old female diagnosed with toxic epidermal necrolysis. She had a history of polypharmacy and medication allergies and presented with a sudden-onset fever, malaise, and a diffuse rash. Clinical examination revealed extensive epidermal detachment involving more than 80% of the body surface area, including mucous membranes. Carbamazepine, administered recently, was identified as the suspected causative agent. The patient was promptly admitted to the intensive care unit for specialized care, including supportive measures, wound care, and close monitoring of fluid and electrolyte balance. Intravenous immunoglobulin therapy was initiated, together with a multidisciplinary approach involving dermatology, ophthalmology, and nutritional support. The patient's condition gradually improved over the following weeks, with re-epithelialization of the affected areas and resolution of systemic symptoms. This case highlighted the importance of early diagnosis, prompt management, and a multidisciplinary approach in optimizing patient outcomes. As toxic epidermal necrolysis is a rare disease, prospective studies, immunogenetic biomarkers, and randomized controlled trials remain limited. Further research in these areas is needed to provide valuable insights into the management of this disease.