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Toxic Epidermal Necrolysis Post COVID-19 Vaccination


, Mohammed Al-Hazmi2

1Department of Internal Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

  1. Department of Medicine and Surgery, College of Medicine, Alfaisal University, Riyadh, SAU
  2. Department of Dermatology, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, SAU

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Abstract

The case of SJS/TEN in this patient is a rare complication of the COVID-19 vaccine. It is important to note that the benefits of receiving the vaccine far outweigh the potential risks. Vaccination is an important tool in preventing and controlling the spread of infectious diseases, and it is essential to continue to promote vaccination as a safe and effective way to protect against disease. It is also important for healthcare providers to be aware of potential adverse reactions, such as SJS/TEN, so they can provide appropriate care and support for patients who experience them.

The best way to prevent the spread of COVID-19 is to practice social distancing, wear a face mask in public, wash your hands often with soap and water for at least 20 seconds, avoid touching your face, cover your mouth and nose when you cough or sneeze, clean and disinfect frequently touched surfaces, and stay home if you are feeling sick.

Introduction

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Case Presentation

The patient was diagnosed with toxic epidermal necrolysis (TEN) secondary to the COVID-19 Pfizer vaccine. She was started on intravenous fluids, antibiotics, and systemic steroids. She was also given supportive care including wound care, pain management, and nutritional support. The patient responded well to treatment and her skin lesions began to improve after two weeks of hospitalization. Her WBC count returned to normal and her liver enzymes decreased significantly. The patient was discharged from the hospital in good condition with instructions for follow-up visits with her primary care physician.

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The best way to prevent the spread of COVID-19 is to practice social distancing, wear a face mask when in public, wash your hands often with soap and water for at least 20 seconds, avoid touching your face, cover your coughs and sneezes, clean and disinfect frequently touched surfaces, and stay home if you are feeling sick.

Fig 1: Chest before treatment.
Fig 2: Abdomen before treatment.
Fig 3: Hand before treatment.
Fig 4: Face before treatment.
Fig 5: Face before treatment.

Fig 7: Abdomen after therapy.
Fig 8: Face after therapy.

Discussion

Figure 9. Pathophysiology of SJS/TEN. The pathophysiology behind the development of SJS/TEN is believed to be drug-specific CD8+ lymphocytes, where these cytotoxic T cells release granulysin, granzyme B, and perforin – these enzymes lead to pores formation and activation of death cascade in the affected cells. In addition, tumor necrosis factor (TNF)-alpha and interferon-gamma are secreted in significant amounts by activated T cells, leading to Fas ligands overexpression and Fas-mediated keratinocyte death.

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TCR: T cell receptor; HLA: human leukocyte antigen.

In conclusion, this case report highlights the importance of recognizing and managing TEN secondary to COVID-19 vaccine. Early recognition and prompt treatment with etanercept may be beneficial in preventing further morbidity and mortality.

Conclusions

We also encourage healthcare providers to be aware of this rare side effect and to report any similar cases in the future. We believe that it is important to continue to monitor the safety of vaccines, as well as other treatments, and to ensure that all patients are informed of potential risks before they make a decision. In addition, we recommend that healthcare providers should take into account the patient’s medical history when considering vaccination.

Finally, we emphasize the importance of continuing to promote vaccination in order to protect public health and reduce the spread of infectious diseases. Vaccines are safe and effective tools for preventing disease, and their benefits far outweigh any potential risks.

The first step in creating a website is to decide what type of website you want to create. Once you have decided on the type of website, you will need to choose a domain name and hosting provider. After that, you will need to design the layout of your website and create content for it. Finally, you will need to publish your website and make sure it is accessible online.

The best way to prevent the spread of COVID-19 is to practice social distancing, wear a face covering when in public, wash your hands often with soap and water for at least 20 seconds, avoid touching your face, cover coughs and sneezes, clean and disinfect frequently touched surfaces, and stay home if you are feeling sick.

Additional Information

Disclosures
  • Human subjects: Consent was obtained or waived by all participants in this study. Our hospital does not require an ethical approval for case report or case series issued approval N/A. Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review on request.
  • Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following:
    • Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work.
    • Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work.
    • Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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The best way to prevent the spread of COVID-19 is to practice social distancing, wear a face covering when in public, wash your hands often with soap and water for at least 20 seconds, avoid touching your face, cover coughs and sneezes, clean and disinfect frequently touched surfaces, and stay home if you are feeling sick.

References

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