Toxic epidermal necrolysis (TEN)/Stevens–Johnson syndrome (SJS) is the spectrum of severe, acute, mucocutaneous, T-cell mediated delayed type IV hypersensitivity reaction and universally related to different drugs. Phenobarbitone is known to cause hypersensitivity reactions with benign pattern; ranging from a mild to moderate rashes but not life-threatening reactions such as TEN/SJS. We report a 14-year-old asthmatic male patient admitted to a local hospital for an acute exacerbation of asthma, after he presented with shortness of breath, cough, and fever. He was treated with bronchodilator and antibiotics. On subsequent days, the patient developed new onset generalized tonic clonic seizure in the hospital for which he was started on phenobarbitone of 100 mg twice daily. Two weeks after initiation of phenobarbitone, the patient developed extensive blistering skin eruptions; which subsequently exfoliated unevenly. Associated with the hypersensitivity skin reaction, the patient reported low grade fever, sore throat, and dysphagia. The exfoliation also involved oral and conjunctival mucosa; with estimated 65% body surface area involvement. The laboratory investigations were relevant for mild leucocytosis, prolonged prothrombin time, and reduced albumin. Phenobarbitone was discontinued and replaced with clonazepam; and the patient was managed with fluids replacement, IV antibiotics, twice daily wound care, analgesics, and naso gastric tube feeding. On subsequent days the patients’ clinical condition started improving; the skin lesion also started to heal and exfoliate in most of the affected skin surface areas, and the patient was discharged improved after ten days of intensive care unit. In summary, the present case describes, a 14-years-old young child with history of asthma and seizure disorder; and developed toxic epidermal necrosis following exposure to Phenobarbitone. This case also highlighted the better prognosis observed in pediatric population with TEN.

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苯巴比妥相关的中毒性表皮坏死：病例报告及文献综述

中毒性表皮坏死松解症 (TEN)/史蒂文斯-约翰逊综合征 (SJS) 是一系列严重、急性、皮肤粘膜、T 细胞介导的迟发性 IV 型超敏反应，普遍与不同药物相关。已知苯巴比妥会引起良性过敏反应；范围从轻度到中度皮疹，但不危及生命的反应，如 TEN/SJS。我们报告了一名 14 岁哮喘男性患者，因出现呼吸短促、咳嗽和发烧等症状，因哮喘急性发作被送往当地医院。他接受了支气管扩张剂和抗生素治疗。随后几天，患者在医院出现新发全身强直阵挛性癫痫发作，并开始服用苯巴比妥，每次 100 毫克，每日两次。开始使用苯巴比妥两周后，患者出现大面积起泡的皮疹；随后剥落不均匀。与过敏性皮肤反应相关，患者报告有低烧、喉咙痛和吞咽困难。剥脱还涉及口腔和结膜粘膜；估计有 65% 的体表面积受累。实验室检查与轻度白细胞增多、凝血酶原时间延长和白蛋白减少有关。停用苯巴比妥并用氯硝西泮替代；患者接受了补液、静脉注射抗生素、每日两次伤口护理、镇痛药和鼻胃管喂养等治疗。在接下来的几天里，患者的临床状况开始改善；大部分受影响的皮肤表面区域的皮损也开始愈合和剥落，患者在重症监护室治疗十天后病情好转出院。总之，本病例描述的是一名 14 岁幼儿，有哮喘和癫痫病史；接触苯巴比妥后出现中毒性表皮坏死。该病例还强调了在 TEN 儿童群体中观察到的更好的预后。