Toxic Epidermal Necrolysis by Ceftriaxone in Patient with Newly Diagnosed Systemic Lupus Erythematosus

Toxic epidermal necrolysis (TEN) is a rare disease in absolute numbers with an incidence of 2 cases per million people per year. Most cases of TEN are caused by drugs, but certain infectious diseases may have an impact on the risk. There are rare reports of TEN occurring without history of drug ingestion in systemic lupus erythematosus (SLE), appearing similar to cutaneous lupus and early TEN manifestations, such as erythema multiforme. This report describes a patient with SLE who presented with manifestations of TEN after ceftriaxone treatment. The patient was newly diagnosed with SLE and TEN occurring eight days after cessation of ceftriaxone. Considering possible etiologies, we could not exclude ceftriaxone as the cause of TEN. After intravenous immunoglobulin with glucocorticoid, clinical symptoms improved.