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CASE REPORT article

Front. Pediatr.
Sec. Pediatric Critical Care
Volume 12 - 2024 | doi: 10.3389/fped.2024.1460579

Multi-targeted Therapy in the Treatment of Severe Toxic Epidermal Necrolysis (TEN) - Case Report

Provisionally accepted
Elaine Yi Lee Kwong Elaine Yi Lee Kwong *Chon In Manson Kuok Chon In Manson Kuok King Fai Lam King Fai Lam Winnie Kwai Yu Chan Winnie Kwai Yu Chan
  • Queen Elizabeth Hospital (QEH), Kowloon, Hong Kong, SAR China

The final, formatted version of the article will be published soon.

    We reported a 10-year-old child who suffered from severe toxic epidermal necrolysis (TEN) triggered by trimethoprim-sulfamethoxazole and managed successfully with multi-targeted therapy.He was jointly managed by the paediatric intensivist, dermatologist, otolaryngologist, urologist, wound nurse, pain management specialist, dietitian and clinical psychologist. Systemic intravenous immunoglobulin (IVIG) and pulsed-dose methylprednisolone were initiated after admission. Oral cyclosporin A was added in the early stage of the disease in view of severe ocular involvement with progressive inflammation of bilateral upper and lower eyelids, presence of pseudomembrane, diffuse conjunctival injection and progression of central epithelial defects in bilateral eyes. He underwent amniotic membrane transplantation. Subcutaneous injection of etanercept was added on the treatment therapy to allow rapid tapering of steroid. Finally, the disease progression was halted with re-epithelisation on day 13. He experienced no side effects from the multi-targeted therapy and recovered well without clinical sequelae.

    Keywords: toxic epidermal necrolysis, Stevens - Johnson syndrome, Trimethoprim- sulfamethoxazole, etanercept, Cyclospoin A, Ocular involvement

    Received: 06 Jul 2024; Accepted: 05 Nov 2024.

    Copyright: © 2024 Kwong, Kuok, Lam and Chan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Elaine Yi Lee Kwong, Queen Elizabeth Hospital (QEH), Kowloon, Hong Kong, SAR China

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