Toxic epidermal necrolysis in a child with lupus-associated pancreatitis

Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening dermatological conditions that are characterized by mucosal erosions, epidermal detachments and erosions. The most common causes of SJS and TEN are drugs; other causes such as systemic lupus erythematosus (SLE), vaccinations and infections have been rarely implicated. We present the case of a 14-year-old female patient with acute pancreatitis as an initial manifestation of systemic lupus erythematosus, complicated by the toxic epidermal necrolysis with a fatal outcome. She initially presented with abdominal pain, fever, vomiting, and intolerance to oral intake and elevated pancreatic enzyme levels. Systemic lupus erythematosus was diagnosed secondary when her condition has been already complicated by the toxic epidermal necrolysis. The administration of corticosteroids and high doses of intravenous immunoglobulin did not lead to positive effects in the treatment of our patient.

Acute pancreatitis: a rare presentation of systemic lupuserythematous (SLE) in paediatric age group

“…Use of steroid treatment for lupus pancreatitis was controversial in past as it was seen that most cases of SLE pancreatitis occur in children with long standing SLE who have multi-organ involvement and are already on immunosuppressive therapy or steroid [8]. Now most of studies proved role of steroid therapy [9,10].…”

Toxic Epidermal Necrolysis, A Serious Side Effect of Tenoxicam Use: A Case Report

“…Oral erosions and crust formation, keratoconjunctivitis, and the loss of nails or eyebrows are commonly observed. Due to keratinocytes necrosis, the epidermis's detachment from the dermis appears (keratinocytes lose their shape and their adhesion ability), which is associated with the formation of extremely painful blisters [58][59][60].…”

Cutaneous Involvement in Systemic Lupus Erythematosus: A Review for the Rheumatologist

“…Rare cases of toxic epidermal necrolysis (TEN)-like ACLE or hyper-acute CLE have been reported, which encompasses clinical and histological findings of both ACLE and toxic epidermal necrolysis together without an inciting drug or infection. 46,47 The majority of patients have a previously confirmed or new diagnosis of SLE or SCLE at the time of TEN-like ACLE. 48…”