Toxic Epidermal Necrolysis by Ceftriaxone in Patient with Newly Diagnosed Systemic Lupus Erythematosus

Toxic epidermal necrolysis (TEN) is a rare disease in abso-lute numbers with an incidence of 2 cases per million peo-ple per year. Most cases of TEN are caused by drugs, but certain infectious diseases may have an impact on the risk. There are rare reports of TEN occurring without history of drug ingestion in systemic lupus erythematosus (SLE), appearing similar to cutaneous lupus and early TEN mani-festations, such as erythema multiforme. This report de-scribes a patient with SLE who presented with manifes-tations of TEN after ceftriaxone treatment. The patient was newly diagnosed with SLE and TEN occurring eight days after cessation of ceftriaxone. Considering possible etiol-ogies, we could not exclude ceftriaxone as the cause of TEN. After intravenous immunoglobulin with glucocorti-coid, clinical symptoms improved. Key Words. Systemic lupus erythematosus, Toxic epi-dermal necrolysis, Ceftriaxone, Hydroxychloroquine, IV immunoglobuli