Single Dose of Etanercept Injection: A Game Changer in Toxic Epidermal Necrolysis: A Case Series
Published: November 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/62912.18615
Rajkumar Kannan, Samuel Jeyaraj Daniel, Parimalam Kumar, Lavanya Kavimani
1. Professor, Department of Dermatology, Venereology and Leprosy (DVL), MMC & RGGH, Chennai, Tamil Nadu, India.
2. Associate Professor, Department of Dermatology, Venereology and Leprosy (DVL), MMC & RGGH, Chennai, Tamil Nadu, India.
3. Professor, Department of Dermatology, Venereology and Leprosy (DVL), MMC & RGGH, Chennai, Tamil Nadu, India.
4. Senior Resident, Department of Dermatology, Venereology and Leprosy (DVL), MMC & RGGGH, Chennai, Tamil Nadu, India.
Correspondence
Dr. Lavanya Kavimani,
Senior Resident, Department of Dermatology, Venereology and Leprosy (DVL), Rajiv Gandhi Hospital, Parktown, Chennai-03, Tamil Nadu, India.
E-mail: lavanyakavimani94@gmail.com
Toxic Epidermal Necrolysis (TEN) is a rare hypersensitivity reaction to drugs, characterised by widespread erythema, full-thickness epidermal necrosis with mucosal involvement, and extensive apoptosis. It is a dermatological emergency and can be lethal if not promptly treated. The use of steroids in managing TEN is controversial since no gold standard therapy exists. However, a single dose of subcutaneous injection of Etanercept (a Tumour Necrosis Factor-alpha (TNF-α) inhibitor) at a dosage of 50 mg has shown promise in preventing mortality and reducing hospital stay. The authors present a case series of six TEN patients, out of which three received a single dose of Etanercept injection. All patients who received Etanercept showed a positive response, achieving complete re-epithelialisation with a median healing time of nine days. In conclusion, injection of Etanercept, a TNF-α inhibitor, effectively inhibits Fas-Fas ligand activation, thus preventing apoptosis and extensive necrosis.
[
FULL TEXT ] | [ PDF]