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Odynophagia as the first manifestation of toxic epidermal necrolysis
  1. Noelia Ortega Beltrá1,
  2. Fernando Guallart Domenech1,
  3. Paula Martínez Ruiz de Apodaca1,1 and
  4. Francisco Pons Rocher1,2
  1. 1Otorhinolaryngology, Hospital Universitario Doctor Peset, Valencia, Spain
  2. 2Cirurgia (Otorhinolaryngology), Universitat de Valencia Facultat de Medicina i Odontologia, Valencia, Spain
  1. Correspondence to Dr Francisco Pons Rocher;{at}


Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are infrequent mucocutaneous diseases, rapidly progressive and life-threatening. The clinical aspects and the management of TEN are exposed following a case.

A man in his 40s presented to the emergency department with severe odynophagia, poor general condition and fever. His medical history was significant for HIV stage AIDS, and the treatment was discontinued 5 years before the present diagnosis. He was admitted for cerebral toxoplasmosis and discharged the previous 14 days with sulfadiazine. Erythematous-bullous lesions in the oral cavity, diffuse erythematous maculopapular rashes over his neck and chest, acute bilateral conjunctivitis and purulent urethritis was observed. The diagnostic suspicion was SJS/TEN due to sulfadiazine in immunosuppressed patients.

This entity is infrequent but is a life-threatening dermatological emergency that requires immediate medical attention. Its diagnosis is mainly clinical, with a new drug history, prodromal symptoms and characteristic cutaneous–mucous lesions. Early diagnosis and rapid withdrawal of the drug improve the prognosis.

  • dermatology
  • drugs and medicines
  • ear, nose and throat
  • HIV / AIDS
  • safety

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  • Contributors NOB—conception and design, reporting and writing of the manuscript and draft preparation, acquisition of data, analysis and interpretation of data. FGD—planning the therapeutic conduct of the patient disease, search and development of multimedia resources for the paper. PMRdA—methodology, analysis and interpretation of data, writing (review and editing), language review. FPR—conception and design, reporting, writing (review and editing), institutional link. All authors have read and agreed to the published version of the manuscript.

  • Funding This study was supported by Universitat de València (200177).

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.