Toxic epidermal necrolysis and co‐existent SARS‐CoV‐2 (COVID‐19) treated with Intravenous Immunoglobulin: “Killing 2 birds with one stone”

Saha, M.; D’Cruz, A.; Paul, N.; Healy, R.; Collins, D.; Charles, D‐A.; Sahu, S.; Fonia, A.

Toxic Epidermal Necrolysis (TEN) is classified as severe cutaneous adverse reaction. It can be induced by drugs, infection, and malignancy or can be idiopathic. We present a 62‐year‐old male of Indian origin with a widespread, tender, erythematous maculo‐papular eruption and targetoid lesions on the palms and soles. He had a history of multiple myeloma and a stem cell transplant in 2008. He was recently started on amoxicillin for a suspected lower respiratory tract infection and lenalidomide, septrin and allopurinol 6 weeks prior to presentation due to a relapse of the myeloma. The rash evolved into large areas of flaccid blistering (over 30% of the body surface area) with severe mucosal involvement (Fig.1a) and a diagnosis of TEN was made.