We report the case of a patient treated with eye drops containing methazolamide, who developed toxic epidermal necrolysis (TEN).A 65‐year‐old Chinese man developed a pruritic rash 20 days after commencing treatment with methazolamide ophthalmic solution daily for retinal detachment. On physical examination, he was found to have an erythematous, maculopapular rash on his lips, chest and soles of his feet, involving > 30% of the body surface area (Fig. a). Heart rate and respiratory rate were normal, but the patient had pyrexia (temperature 40 °C), and acantholysis sign was positive. The patient's score on the Naranjo adverse drug reaction probability scale was 5. Based on the clinical symptoms and physical examination, TEN secondary to methazolamide ophthalmic solution was diagnosed, and the drug was discontinued immediately.Erythematous, maculopapular rash on (a) the trunk, (b) lips, (c) feet and (d) hands, with (b) erosions in the mouth.The following laboratory tests were all normal or negative: absolute neutrophil count, liver and kidney function tests, and serology testing for hepatitis B and C and human immunodeficiency virus. The patient was treated with methylprednisolone 40 mg daily.Four days later the lesions had not resolved. Erosions were observed in the oral cavity (Fig. b), and the rash had extended to the face, extremities,
Clinical & Experimental Dermatology – Wiley
Published: Jan 1, 2018
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