Abstract
Introduction: We report a case where oral symptoms, initially suspected as adverse effects of chemoradiotherapy, evolved into systemic mucositis and dermatitis, leading to a toxic epidermal necrolysis (TEN) diagnosis.
Case Report: An 80-year-old man presented for conservative treatment of tongue cancer. Based on his preference, superselective intra-arterial chemoradiotherapy was chosen instead of surgery. Thirty-six days after treatment began, the patient developed a fever of 38.4°C and worsening oral mucositis (grade 3 CTCAE Ver. 4.0). Subsequently, facial dermatitis appeared and was initially diagnosed as radiation dermatitis, leading to topical steroid therapy. However, skin symptoms with blisters and erosions spread across the body. Stevens-Johnson syndrome (SJS) and TEN were strongly suspected, and systemic corticosteroid therapy was initiated. A biopsy and clinical symptoms confirmed TEN. Corticosteroids were tapered and discontinued by day 62. The patient’s symptoms improved. Seventeen months later, multiple lung metastases were observed, and the patient died of primary disease.
Discussion: Severe drug eruptions during chemoradiotherapy are difficult to diagnose because they must be differentiated from adverse events caused by the therapy itself.
Conclusion: We should consider a possibility of SJS/TEN during chemoradiotherapy for head and neck cancer.
Recommended Citation
Takeuchi, Terumi; Sakaguchi, Tatsuya; Nishi, Kentaro; Munakata, Kanako; Karube, Takeshi; Soma, Tomoya; Nakagawa, Taneaki; and Asoda, Seiji
(2025)
"Toxic epidermal necrolysis developing during superselective intra- arterial chemoradiotherapy for tongue cancer: A case report,"
Journal of Dentomaxillofacial Science: Vol. 10:
Iss.
4, Article 14.
DOI: https://doi.org/10.15562/jdmfs.v10i4.1857
Available at:
https://scholarhub.unhas.ac.id/jdmfs/vol10/iss4/14
Pages
240-243
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Rights
©2025Terumi Takeuchi, Tatsuya Sakaguchi, Kentaro Nishi, Kanako Munakata, Takeshi Karube, Tomoya Soma, Taneaki Nakagawa, Seiji Asoda
DOI
10.15562/jdmfs.v10i4.1857