A Case Report on Ibuprofen Induced Toxic Epidermal Necrolysis

Abstract

Ibuprofen is a non steroidal anti-inflammatory drug that exhibits analgesic and antipyretic activities by inhibiting prostaglandin synthesis. Though available as an OTC drug, ibuprofen is potent enough to cause serious dermatologic adverse reactions like erythema multiforme,  erythroderma,  SJS  (Stevens  -  Johnson  syndrome),  TEN  (toxic  epidermal  necrolysis).  TENis  a  potentially  life  threatening dermatologic disorder and a severe cutaneous ADR that involves skin and mucous membrane, characterized by widespread erythema, necrosis and bullous detachment, resulting in exfoliation & possible sepsis and/or death, which is most commonly drug induced. Toxic epidermal necrolysis is characterized by inappropriate immune activation in response to certain medications or their metabolites. The exact pathogenic mechanism of TEN is still uncertain. The exposure to drugs has increased with demographic shifts associated with a higher morbidity of the population. Along with this phenomenon, a rise in the incidence of adverse drug reactions (ADRs) has been observed.   Hypersensitivity- syndrome associated with ibuprofen is a host-dependent idiosyncratic drug-reaction. Though ibuprofen is most widely used over the counter (OTC) medication, which is considered to be relatively safe, it is essential to understand its potential adverse effects. This rare case report addresses the fact that severe hypersensitivity reactions can occur with ibuprofen, which can be potentially dangerous and life threatening. This case report also adds a note on the diagnosis and management of Toxic Epidermal Necrolysis.