Toxic epidermal necrolysis (TEN) after sclerosing tissue glue injection in oesophageal variceal ligation in patients with liver malignant tumors: A case report

Abstract

Abstract Background Toxic epidermal necrolysis (TEN) is one of the few allergic diseases with an acute onset and severe symptoms in dermatology. Drugs are the most important pathogenic factors for this condition. Referring to the relevant literature, TEN after endoscopic surgery has been rarely reported. Case presentation: A 58-year-old male patient with chronic liver disease was treated with oesophageal variceal ligation, sclerosing agent and tissue glue injection due to oesophageal and gastric variceal bleeding. After 2 days, the patient’s skin exhibited erythema to different degrees. After 10 days of dexamethasone treatment, the whole-body rash worsened, and a severe skin reaction appeared, which was suggestive of toxic epidermal necrolysis (TEN). Strict mucosal care was provided, and corticosteroids, gamma globulin and adalimumab were concurrently used for treatment. After 20 days, the patient recovered from the skin problems. Conclusion Combined with domestic and international case reports, this may be the first case report of toxic epidermal necrolysis after sclerosing tissue glue injection in oesophageal variceal ligation. When patients with multiple drugs have multiline erythema, physicians should be alert to the possibility of its development into TEN. This article summarizes the experiences of this patient and related diagnoses and treatments at home and abroad, which provides a practical clinical basis and experience for the diagnosis and treatment of TEN in the future.