Combined corticosteroid and etanercept therapy in toxic epidermal necrolysis

Abstract

The authors present the case of a 34-year-old female patient hospitalized for lamotrigine-induced toxic epidermal necrolysis (TEN). The initial clinical presentation suggested TEN with cutaneous, oral, and genital mucosal involvement, which was later confirmed by histopathological examination. Because of the progression observed with the high-dose systemic corticosteroid treatment, etanercept was added to the therapy on the second day of hospitalization. The patient received a total of 2x50 mg etanercept subcutaneously, three days apart. The corticosteroid dose could be gradually reduced, the progression of disease stopped, and no adverse effects were observed. Due to the rarity of the disease, there is little evidence on therapeutic options for TEN. To our knowledge, the treatment was provisioned by licensing of Health Authorities our case was the first in Hungary to apply the TNF-α inhibitor etanercept in TEN and our results support the available data in the literature that the combination of corticosteroids with etanercept may be a safe and effective treatment in TEN and may reduce the dose of corticosteroids and recovery time.