Toxic epidermal necrolysis following SARS-CoV2 vaccine. A case report

Background

66-year-old female with a history of arterial hypertension of 3 months of diagnosis and colon cancer of 13 years of diagnosis with partial colectomy on two occasions and second-line treatment with imatinib from 2018 to June 2021 with subsequent change to sunitinib in September of 2021 for presenting a recurrence, who received the vaccination schedule against SARS-CoV2 with a third dose from the Pfizer laboratory applied on November 11, 2021. Symptoms began approximately 18 hours after the administration of the vaccine with pain at the application site, after After 24 hours, intense itching was added, lesions on the oral and ocular mucosa made up of ulcers, later he presented multiple red erythematous macules that spread in a cephalo-caudal direction, forming blisters and flaccid blisters of 3 to 25 cm in diameter, some de-epithelialized, forming superficial ulcers. , Nikolsky sign and positive Asboe-Hansen in addition to acute kidney injury. She received treatment with fluid replacement, antihypertensive management, corticosteroids, analgesics, and cleaning of the wounds with antiseptic dressings and hydrocolloid patches in the most extensive lesions, monitoring of the hemodynamic pattern, and evaluation by ophthalmology with the application of antibiotics, steroids, and artificial tears. With the improvement of the clinical picture, progressive weaning of the corticosteroid was carried out and discharge from the intensive care unit was decided. No recurrences were reported after discharge.

Keywords: SARS-CoV2 vaccine, Toxic epidermal necrolysis.