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Levamisole induced toxic epidermal necrolysis: A case report
Author(s) -
Rohilla Rachna,
Jain Arihant
Publication year - 2021
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.14533
Subject(s) - toxic epidermal necrolysis , levamisole , medicine , dermatology , allopurinol , drug , immunology , pharmacology
Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life‐threatening immune‐mediated hypersensitivity reactions. Various drugs, such as Non Steroidal Anti‐inflammatory drugs (NSAIDS), allopurinol, anticonvulsants and antibiotics, have been implicated as triggering agent of SJS/TEN. Levamisole is frequently used as an antihelminthic and as an immunomodulator in cases of nephrotic syndrome. However, levamisole has not been reported as a trigger for SJS/TEN. The current case describes levamisole‐induced TEN in a 15‐year‐old male who presented to emergency with erythematous lesions, blistering and denudation of skin involving up to 30% of body surface area. Algorithm of drug causality for epidermal necrolysis scoring was applied for causality assessment and a relationship was found to be “possible”. Immediate withdrawal of levamisole along with a short course of corticosteroids and cyclosporine led to improvement in signs and symptoms. Clinicians should be aware of the possible association of levamisole and SJS/TEN.