Chronic viral infection and toxic epidermal necrolisis (Lyell´s syndrome)

Abstract

Two cases of toxic epidermal necrolysis (Lyell's syndrome) are described. The introduction discusses the relevance of this problem. Emphasis is placed on the differential diagnosis of Lyell's syndrome with Stevens-Johnson syndrome, since both syndromes are difficult to distinguish in the debut. As differential diagnostic criteria, it is recommended to take into account the presence of Nikolsky's symptom and the area of involvement in the pathological process of the skin more than 30%. In the manifestation of Lyell's syndrome, the role of genetic predisposition is not excluded. The presented observations indicate that the first clinical symptoms are identical. In both cases, the disease was triggered by medications first used. The common background was viral infection: long-term chronic HCV-infection in combination with herpes zoster and HIV-infection without antiretroviral therapy. Our observations expand our understanding of the likely predisposing factors of Lyell's syndrome, which can include acute and long-term chronic viral infections.