Biologics to the Rescue in Case of Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis

Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious adverse drug reactions, triggered by medications, infections, malignancies and idiopathic causes. Clinically, they manifest as widespread, painful erythematous macules and target-like lesions, often accompanied by full-thickness or localised epidermal necrosis. Our patient, a 33-year-old male, presented with oral ulcers and painful red lesions starting from the face and progressing to involve trunk and upper extremities 5 days after administration of intravenous diclofenac for severe headache. Additional symptoms included ulceration over lips and buccal mucosa. He was diagnosed clinically as a case of SJS-TEN overlap with Severity of illness score for toxic epidermal necrolysis (SCORTEN) of 3 and was given intravenous corticosteroids. Here, we report a case of SJS-TEN overlap with corticosteroids-induced acute psychosis, treated successfully with etanercept monotherapy.