The First Documented Ibuprofen-Induced Toxic Epidermal Necrolysis in the Middle East and North Africa Region: A Case Report, Complications, and Management.

Autor:	Kheir K; Department of General Medicine, Faculty of Medical Sciences, Lebanese University, Beirut, LBN., Abdallah RM; Department of Allergy and Immunology/Internal Medicine, Faculty of Medical Sciences, Lebanese University, Beirut, LBN., Sleiman Z; Department of Plastic and Reconstructive Surgery, Lebanese Hospital Geitaoui - University Medical Center, Beirut, LBN., Mallat H; Department of Infectious Diseases, Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, LBN., Haddad F; Department of Internal Medicine and Clinical Immunology, Lebanese Hospital Geitaoui - University Medical Center, Beirut, LBN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Nov 28; Vol. 15 (11), pp. e49608. Date of Electronic Publication: 2023 Nov 28 (Print Publication: 2023).
DOI:	10.7759/cureus.49608
Abstrakt:	Introduction: Stevens-Johnson syndrome (SJS), Stevens-Johnson/toxic epidermal necrolysis overlap syndrome (SJS/TEN) and toxic epidermal necrolysis (TEN) are rare, acute, potentially lethal conditions, considered to be part of the severe cutaneous adverse reactions (SCARs) spectrum, with TEN being the most life-threatening. The distinction between these three entities is based on the extent of total skin surface involvement, with SJS involving < 10%, SJS/TEN involving 10-30% and TEN involving > 30% of total body surface area. These mucocutaneous reactions are most commonly caused by a hypersensitivity reaction to a drug, with infections and vaccines being possible, less common etiologies. Case Presentation: In the following case report, we summarize a rare case of a 43-year-old, previously healthy male patient who presented with TEN after taking ibuprofen, a non-steroidal anti-inflammatory drug. According to PubMed literature, this is the first documented case of ibuprofen-induced TEN in the Middle East and North Africa (MENA) region. Discussion: TEN is an autoimmune bullous disorder that results in the death of keratinocytes, leading to complete dermo-epidermal separation. In the case of our patient, the desquamation was extensive, involving 70% of the total body surface area, and was complicated by a triple bacterial infection with Acinetobacter baumannii , Klebsiella pneumoniae , and Pseudomonas aeruginosa . The patient was treated with colistin and meropenem, in addition to supportive management, hydration and nutritional support. Conclusion: In the case of TEN, early diagnosis and hospitalization in a burn centre are crucial to allow rapid healing, and improve the quality of life of the affected patients. Immediate cessation of the causative mediation is critical. Supportive management, hydration, nutritional support, and maintenance of aseptic conditions are highly encouraged to reduce the mortality and morbidity associated with TEN. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Kheir et al.)
Databáze:	MEDLINE
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