Toxic epidermal necrolysis induced by lansoprazole
A previously healthy, 23-year-old woman, began to have ocular and vaginal itching and later symmetrical erythematous macules appeared on the limbs, mainly hands and feet. Within 7 days there was significant spread of lesions, which evolved into blisters. She sought the emergency care unit, where prednisone 2 mg/kg was administered. After 2 days, she was transferred to our service. She reported use of lansoprazole 15 days before the appearance of the lesions.\nOn examination, the patient was pale 2+/ 4 + , febrile and tachycardic. Epidermal detachment involved more than 90% of the body surface, and there were some areas of erosion ( and ). Mild involvement of the oral mucosa and lips with crust formation. She was admitted to the intensive care unit, lansoprazole was stopped and intravenous immunoglobulin, 2 g/kg was administered for 3 days, in addition to skin debridement and daily dressings. The patient developed significant reepithelialization in 15 days ( and ). After two months, she presents only residual hyperchromic macules.