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Severe toxic epidermal necrolysis precipitated by amphetamine use
Author(s) -
Roberts Hugh,
Chamberlain Alexander,
Rennick Gordon,
McLean Catriona,
Gin Douglas
Publication year - 2006
Publication title -
australasian journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.67
H-Index - 53
eISSN - 1440-0960
pISSN - 0004-8380
DOI - 10.1111/j.1440-0960.2006.00243.x
Subject(s) - toxic epidermal necrolysis , medicine , maculopapular rash , rash , dermatology , staphylococcus aureus , candida albicans , pseudomonas aeruginosa , total body surface area , antibody , erythroderma , trunk , surgery , immunology , microbiology and biotechnology , bacteria , biology , genetics , ecology
SUMMARY A 48‐year‐old man presented with a maculopapular truncal rash 9 days following intravenous amphetamine use. He subsequently developed widespread bullae over his trunk and upper limbs. Treatment was initially commenced with intravenous hydrocortisone. A diagnosis of toxic epidermal necrolysis was made and the treatment was changed to intravenous immunoglobulin at a lower dose than requested. At the height of the reaction, there was 90% body surface area involvement with tri‐mucosal involvement. His response to the intravenous immunoglobulin was poor and was complicated by infection with methicillin‐resistant Staphylococcus aureus , Candida albicans and Pseudomonas aeruginosa . Gradual re‐epithelialization took place over the next 6 weeks.