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Case Reports in Dermatological Medicine
Volume 2012, Article ID 915314, 3 pages
Case Report

Combination of Infliximab and High-Dose Intravenous Immunoglobulin for Toxic Epidermal Necrolysis: Successful Treatment of an Elderly Patient

1Department of Skin and Venereal Diseases, University of Ioannina Medical School, 45110 Ioannina, Greece
2Department of Internal Medicine, Kozani General Hospital, 50100 Kozani, Greece
3Dermatology Service, Kozani General Hospital, 50100 Kozani, Greece

Received 4 July 2012; Accepted 3 September 2012

Academic Editors: S. Inui, J.-H. Lee, and A. A. Navarini

Copyright © 2012 Konstantinos Patmanidis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Toxic epidermal necrolysis (TEN) is a rare, severe cutaneous adverse drug reaction with average mortality 25–35%, especially among elderly multimorbid patients. Established therapeutic guidelines do not exist and controversies underlie many of the presently suggested treatment regimens. Herein we present the use of the recently described combination scheme of methylprednisolone (500 mg methylprednisolone bolus i.v.) followed by infliximab (5 mg/kg i.v.) and high-dose intravenous immunoglobulin (2 g/kg over 5 days) to treat an elderly, 74-year-old female patient with TEN (SCORTEN 3) within the premises of a district hospital. Already from the second day of hospitalization the skin condition markedly stabilized and the patient's status improved rapidly thereafter. She was discharged after 19 days in stationary care in excellent general condition and remained without any sequels 9 months afterwards. The present paper further supports the feasibility, efficacy, and safety of the proposed combination modality for the treatment of elderly patients with TEN, a population susceptible to more severe TEN.