[Exudative erythema multiforme with transition to a toxic epidermal necrolysis after taking aceclofenac (Beofenac)].

HISTORY AND CLINICAL FINDINGS: A 75-year-old woman took aceclofenac (100 mg/day) for 15 days for long-standing arthritis. Starting with erythema of the face she developed multiple target lesions with central bullae on her neck, chest, back, including the palmoplantar region. In several areas the lesions became confluent and showed wide detachment. The mucous membranes of the eyes, mouth and genitalia also showed marked inflammation, most prominent were large erosions in the mouth. The clinical course culminated in an overall skin loss of about 15 % of the total body surface area.

DIAGNOSIS, TREATMENT AND COURSE: Treatment with topical and systemic corticosteroids as well as antiseptics resulted in complete clearing of the cutaneous lesions within 4 weeks. Various analgetics, particularly the closely related diclofenac, were tolerated without any side-effects after oral intake. Re-exposition with aceclofenac was rejected due to safety reasons.

CONCLUSION

This is the first report of a potentially life-threatening adverse cutaneous drug reaction after taking with aceclofenac.