Toxic epidermal necrolysis caused by over the counter eyedrops.
Summary of "Toxic epidermal necrolysis caused by over the counter eyedrops."
We present a case of a 15-year-old boy who developed toxic epidermal necrolysis (TEN) from sulfacetamide eyedrops. He presented with conjunctival injection and an erythematous rash that rapidly progressed to epidermal necrosis of over 30% of his body. A skin biopsy revealed an acute lichenoid reaction pattern consistent with TEN. After 22 days in hospital, he was left with significant scarring to his eyes, mouth and anogenital areas. An extensive search for an infective aetiology was negative. Previously exposed to bactrim tablets, he used Bleph-10 eyedrops 3 days before admission to hospital. The patient had a strong family history of sulphur allergy. The onset of TEN after topical administration of medication has been reported rarely in the literature. This case highlights the need for a thorough medication history that includes topical preparations.
Affiliation
Mackay Base Hospital, Mackay.
Journal Details
This article was published in the following journal.
Name: The Australasian journal of dermatology
ISSN: 1440-0960
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22897159
- DOI: http://dx.doi.org/10.1111/j.1440-0960.2012.00936.x
Medical and Biotech [MESH] Definitions
Exfoliatins
Protein exotoxins from Staphylococcus aureus, phage type II, which cause epidermal necrolysis. They are proteins with a molecular weight of 26,000 to 32,000. They cause a condition variously called scaled skin, Lyell or Ritter syndrome, epidermal exfoliative disease, toxic epidermal necrolysis, etc.
Epidermal Necrolysis, Toxic
An exfoliative disease of skin seen primarily in adults and characterized by flaccid bullae and spreading erythema so that the skin has the appearance of being scalded. It results primarily from a toxic reaction to various drugs, but occasionally occurs as a result of infection, neoplastic conditions, or other exposure.
Behind-the-counter Drugs
Medicines that are stocked behind the counter of a pharmacy which require the attention or counsel of a pharmacist before being dispensed or handed over to a consumer or patient.
Pityriasis Lichenoides
A subgroup of PARAPSORIASIS itself divided into acute and chronic forms. The acute form is characterized by the abrupt onset of a generalized, reddish-brown, maculopapular eruption. Lesions may be vesicular, hemorrhagic, crusted, or necrotic. Histologically the disease is characterized by epidermal necrolysis. The chronic form shows milder skin changes with necrosis.
Multi-ingredient Cold, Flu, And Allergy Medications
A broad category of multi-ingredient preparations that are marketed for the relief of upper respiratory symptoms resulting from the COMMON COLD; ALLERGIES; or HUMAN INFLUENZA. While the majority of these medications are available as OVER-THE-COUNTER DRUGS some of them contain ingredients that require them to be sold as PRESCRIPTION DRUGS or as BEHIND-THE COUNTER DRUGS.
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