Co-occurrence of toxic epidermal necrolysis in a human immune deficiency virus infected person due to elthrombopag or ofloxacin – a rare occurrence

Toxic epidermal necrolysis (TEN), a severe drug reaction which is more commonly seen in human immune deficiency virus (HIV) infected persons. It occurs commonly with anti-retroviral treatment and sulfonamides. TEN is reported previously with ofloxacin. But there are no reported cases of elthrombopag induced TEN. Early identification and withdrawal of the culprit will enhance rapid recovery and less mortality. Reporting the noted medications vulnerable for TEN will help medical personal in identifying the drug reaction and causative.

We are reporting a 45 years old male with HIV infection developed TEN with elthrombopag and ofloxacin. We identified skin tenderness of erythematous maculopapular lesions as an early identification feature for TEN before appearing typical mucosal lesions, dusky red necrotic skin patches or nikolsky sign.