A 28-year-old patient of neurocysticercosis develops generalized peeling of skin all over except palms and soles staing one month after taking anti-epileptics. What is the most probable diagnosis?
(A) Fixed drug eruption (B) Pemphigus (C) Steven Johnson syndrome (D) TEN
(D) Ans: D. TEN (Ref Neena Khanna 4/e p83, 174)Probable diagnosis is toxic epidermal necrolysis.Toxic epidermal necrolysis (TEN/ Lyell's syndrome:Rare, life-threatening skin condition that is usually caused by a reaction to drugs.Etiology of Epidermal Necrolysis Drugs MiscellaneousIdiopathic Anticonvulsants: Carbamazepine, phenytoin barbiturates, lamotrigineChemotherapeutic agents: sulfonamides, penicillinNSAIDs: Butazones, oxicams Others: Allopurinol, nevirapine SSE, GVHD, Lymphoreticular malignanciesInfections (Mycoplasma pneumoniae, herpes virus infection) 5% of patients