Ho Chi Minh City Dermatology Hospital has just successfully treated patient P.T. L. (51 years old, residing in An Giang) suffering from Lyell's syndrome, also known as epidermal necrosis poisoning. This is a rare drug reaction but can progress quickly, causing damage to the skin, mucous membranes, many organs and threatening life.
About 3 days before being hospitalized, Mr. L. had itching and eye pain, so he went to a nearby pharmacy to buy eye drops. The patient instilled the medicine three times, 2 drops into both eyes each time according to the instructions on the box.
About 5 minutes after the third vaginal discharge, he felt that the inside of his mouth began to blister. When he touched it with his tongue, the mucous membrane patches peeled off and bled profusely.
By late afternoon, my tongue turned white, it was painful and burning, I was very tired. A few hours later, my body turned purple, stiff, almost no feeling left, so my family took me to the district hospital for emergency treatment" - Mr. L. recounted.
According to the family, at that time, the skin on the palms of the hands, soles of the feet, back and abdomen of the patient was blistered and oozed fluid. He also had difficulty breathing, limbs cramped, lips swollen and ulcerated, and eyes with many glaucoma.
Notably, about 6 years ago, the patient was allergic to the same type of eye drops but the symptoms were milder. After being treated at the district hospital, he was transferred to a provincial hospital. Because the condition did not improve after one day of treatment, the family continued to take the patient to Ho Chi Minh City Dermatology Hospital.
BSCKII Nguyen Thi Minh Anh - Deputy Head of Clinical Department 3, Ho Chi Minh City Dermatology Hospital - said that when admitted to the hospital, the patient suffered from severe mouth ulcers, blood clogged lips, burning pain and could not eat and drink normally.
Many loose blisters, about 3-4cm2 in size, appear on the body and soles of the feet. Congestion of the conjunctiva of both eyes, and the mucous membrane of the genital area is also damaged. These are typical manifestations of toxic epidermal necrosis.
After about a week of intensive treatment, the patient's condition improved significantly. Skin lesions gradually heal, the edematous area decreased, eye bleeding decreased, mucosal ulcers gradually dried and the patient could eat and drink again.
After nearly 3 weeks, the patient's condition stabilized, no new blisters appeared. Skin damage onto young skin; mucous membranes of the mouth, lips, eyes and genitals recovered well. Patients can eat, drink, and live normally.
According to Dr. Minh Anh, eye drops are generally safe when used as prescribed. However, part of the drug can be absorbed through the conjunctiva into the general circulation, thereby causing systemic allergic reactions in people with sensitive constitutions or who have been allergic to the drug.
Doctors warn people who have been allergic to a drug not to arbitrarily reuse that drug or the same group of drugs. In subsequent exposures, allergic reactions can occur faster and more severely.
After using the medicine, if a widespread rash appears, blisters, skin pain, mouth ulcers, red eyes, fever, damage to the genital mucosa, swollen lips, swollen tongue, shortness of breath or severe fatigue, the patient needs to stop taking the suspected medicine and immediately go to a medical facility.
