Toxic Epidermal Necrolysis: A Clinical Case Report with Emphasis on Diagnosis, Management, and Prognostic Implications

Abstract

Toxic epidermal necrolysis (TEN) is a rare, life-threatening dermatologic emergency characterized by extensive keratinocyte apoptosis, resulting in widespread epidermal detachment and mucosal involvement. Its pathogenesis is primarily linked to an immune-mediated response triggered by certain medications. This report presents a case of a 45-year-old female who developed TEN following administration of an antibiotic regimen. The patient exhibited progressive skin detachment affecting over 30% of the body surface area, with concurrent ocular and oral mucosal involvement. Despite initial delays in diagnosis, aggressive management with fluid resuscitation, prompt drug discontinuation, and systemic immunosuppressants led to stabilization and eventual recovery. This case highlights the importance of early recognition, the need for a multidisciplinary approach, and the challenges in managing complications such as secondary infections and multi-organ dysfunction. Additionally, we discuss the diagnostic criteria, therapeutic options, and the role of emerging therapies, providing a comprehensive overview for clinicians facing similar cases.