Pralatrexate-Induced Toxic Epidermal Necrolysis

Abstract

SCORTEN is an seven parametered index which is developed for TEN in order to predict the severity of disease and risk of mortality. One point is given for each of the following factors: 1) age > 40 years 2) malignancy 3) serum bicarbonate 120/minute 5) serum glucose > 252 mg/dl 6) epidermal detachment > 10% of body surface area 7) serum blood urea nitrogen >28 mg/ dl.4 The mortality rate of TEN is approximately 25% to 30%. The mortality risk increases accord- ing to SCORTEN score. Mortality rate is 90% for those with ≥ 5 points in SCORTEN parametres.5 It has recommended that SCORTEN score has been evaluated on day 1and day 3 in hospitaliza- tion for TEN diagnosed patient.6 In our case , SCORTEN score for day 1 was graded four and it was graded six for day 3. In addition- ally, we observed a serious grade 4 myelosupres- sion due to pralatrexate. Antifolate drugs cause, focal or widespread epi- dermal necrosis.the skin reaction is high probably