Toxic Epidermal Necrolysis: A Rare Entity to Be Considered

Abstract

Non-small cell lung cancer is a common, high-mortality type of malignancy. Immunotherapy with immune checkpoint inhibitors, such as pembrolizumab, is a recent therapeutic option. Although skin alterations are common adverse effects of these drugs, serious reactions, such as toxic epidermal necrolysis, are rare. This high-mortality disease is characterized by the desquamation of the skin and mucous membranes. In this case, we present a 61-year-old man with metastatic lung adenocarcinoma, undergoing chemotherapy and pembrolizumab. Initial hospitalization was due to sepsis with multiorgan dysfunction. Simultaneously, the patient presented very flaking skin, which worsened throughout the hospital stay, with a subsequent fatal diagnosis of toxic epidermal necrolysis secondary to pembrolizumab. A high diagnostic suspicion is essential for the early recognition and treatment of this disease, to reduce morbidity and mortality.