Management of Toxic epidermal necrolysis Using Early Combination Therapy of intravenous immunoglobulin and Amniotic Membrane Grafting: A Case Report.

Toxic epidermal necrolysis (TEN) is a devastating challenge faced by wound care practitioners. However surgical management with amniotic membrane graft (AMH) promises better results in scar healing, but there is a lack of additional intervention to reduce the high mortality rate in those patients who are admitted with poor prognosis clinical situation. There is supportive evidence that combination therapy with AMG and early high dose intravenous immunoglobulin (IVIG) as early management in TEN could improve the prognosis. In this study, the authors present a 61-year-old female who presented with a widespread macular lesion on the trunk, upper extremities and face. The patient was treated with early amniotic membrane grafting and high dose IVIG and achieved satisfactory results. Complete wound healing was achieved in 21 days. There were no acute or chronic complications, consisting of infection of the skin areas, gastrointestinal bleeding, pleural effusion, and severe ocular mucous membrane damage.