Bronchiolitis obliterans due to toxic epidermal necrolysis with structural evaluation using computed tomography bronchography: A case report.

BACKGROUND

Toxic epidermal necrolysis (TEN) can lead to various extracutaneous complications, including respiratory involvement. We present a case of a patient who developed bronchiolitis obliterans (BO) after the acute phase of TEN, with computed tomography (CT) bronchography revealing bronchial tree structural changes.

CASE PRESENTATION: A 60-year-old woman presented with a rash and hoarseness 2 days after taking ibuprofen and was diagnosed with TEN. While her cutaneous symptoms improved by day 20, the flow-volume loop indicated obstructive respiratory failure. CT bronchography revealed bead-like changes and mural irregularities in the bronchi; thus, BO was diagnosed. Despite treatment with bronchodilators and steroids, she required long-term mechanical ventilation with persistent bronchial alterations.

CONCLUSION

Extracutaneous complications of TEN are crucial, particularly in BO development following the acute phase. In this case, CT bronchography showed treatment-refractory bead-like changes and mural irregularities in the bronchioles.