Toxic epidermal necrolysis following morbilli‐parotitis‐rubella vaccination

Abstract

We present the first reported case of toxic epidermal necrolysis (TEN) caused by morbilli-parotitis-rubella (MPR) vaccine. A 13-year-old girl developed TEN 7 days after she received live, attenuated, triple MPR vaccine. The history of drug intake and any illness was negative. At admission the patient was acutely ill with high fever. The whole body was erythematous. The epidermis was wrinkled and the Nikolsky sign was positive. Numerous erosions were present on the lips and genital region. On the seventh day of illness, the eruption involved 80% of the skin. Systemic corticosteroid therapy was not employed. The skin and mucosal defects completely epithelized by the end of the third week of illness. Mild keratoconjunctivitis sicca remained because of permanent cup cell damage.

Toxic epidermal necrolysis: Review of pathogenesis and management

“…13 There are also case reports of vaccination and M pneumoniaeeinduced TEN. 14,15 GENETIC ASSOCIATIONS IN TEN A landmark paper in 2004 from Chung et al 16 described the association of carbamazepine-induced SJS/ TEN with the HLA-B*1502 allele among Han Chinese (odds ratio [OR] 895; P \ .001). This is the strongest known HLA-disease association so far described and it has been confirmed in other Southeast Asian populations.…”

Toxic epidermal necrolysis

“…The condition has followed vaccinations, such as measles, mumps, and rubella, and exposure to industrial chemicals and fumigants. [34][35][36][37] Infection with Mycoplasma pneumoniae is a known cause of SJS, and a few cases of TEN have been reported to complicate infection with this agent. [38][39][40][41] For all practical purposes, though, drugs are the main cause.…”

Toxic Epidermal Necrolysis Post COVID-19 Vaccination - First Reported Case

“…Medication is usually the cause of TEN (e.g., certain antibiotics and antiepileptics) [3]. Vaccination-induced Stevens-Johnson syndrome (SJS)/TEN is rare, with less than twenty reported cases in the published literature, with the measles vaccine being reported to cause both SJS and TEN, varicella, smallpox, anthrax, tetanus, and influenza vaccines were reported to cause SJS alone, and MMR (measles, mumps, rubella), hantavirus and meningococcal B vaccines were reported to cause TEN [4,5,6]. The patient usually develops a fever and other flu-like symptoms one to three weeks after being exposed to medication followed by painful erythematous to purpuric skin lesions that tend to coalescence.…”