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Two cases of toxic epidermal necrolysis induced by deflazacort in patients with nephrotic syndrome
( Seon Bok Lee ) , ( Ji Hye Heo ) , ( Hee Seong Yoon ) , ( Si Hyub Lee ) , ( Seung Dohn Yeom ) , ( Ji Won Byun ) , ( Jeonghyun Shin ) , ( Gwang Seong Choi )
UCI I410-ECN-0102-2021-500-000107329
This article is 4 pages or less.

Toxic epidermal necrolysis(TEN) is an acute life-threatening mucocutaenous reaction characterized by extensive necrosis and detachment of the epidermis. Drugs are assumed as the main etiologic factor of TEN. The pathogenesis is still uncertain, but TEN is probably resulted by widespread apoptosis of keratinocytes provoked by drug-specific cytotoxic T lymphocytes. Although TEN can be treated by systemic corticosteroids, it may be induced by steroids. Nephrotic syndrome(NS) is treated with steroids such as prednisolone (PD). Due to fewer sides effects and its equivalent anti-inflammatory efficacy to PD, deflazacort (DFZ; oxazoline derivative of PD) has been recommended. We experienced two patients with NS diagnosed with TEN induced by DFZ.The first case was a 41-year old man presented with pruritic erythematous targetoid maculopatches with central vesicles all over the body. The second case was a 9-year old boy presented with pruritic dusky erythematous maculopatches with bullae all over the body. Both patients had been treated with DFZ for NS and there were no other suspicious factors in history taking. Histopathologic findings showed marked necrotic keratinocytes and perivascular lymphohistiocytic infiltration in dermis. Based on clinical and histopathological findings, TEN induced by DFZ was diagnosed. Herein, we report interesting and rare cases of Toxic Epidermal Necrolysis induced by Deflazacort in patients with Nephrotic syndrome.

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