Chemotherapy induced toxic erythema mimicking toxic epidermal necrolysis: a case report

Toxic erythema of chemotherapy (TEC) refers to a variety of skin eruptions secondary to the use of antineoplastic drugs. We report a case of 49-year-old female, diagnosed case of right- side Ca breast, on chemotherapy for 3 months after MRM, who presented with gradually progressive skin rash on bilateral dorsa of hands, forearms, neck folds, bilateral axilla, groins, perianal area and buttocks with pain and burning sensation on lesions. Sloughed skin, denudation, and ruptured bullae generate a broad range of differential diagnoses, including toxic epidermal necrolysis (TEN), PNP and acute GVHD. Topical corticosteroids applied two to three times daily for several weeks can be beneficial in treating affected areas in TEC along with dose reduction of offending agent, extending the interval between treatment cycles, or discontinuing the offending chemotherapeutic agent.