Toxic epidermal necrolysis (Lyell’s syndrome) in a patient with HIV infection

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Lyell’s syndrome, or toxic epidermal necrolysis, is a skin disorder characterized by extensive exfoliation of the epidermis. The prognosis for this disease is poor due to damage to the visceral organs, electrolyte disturbances and the risk of infection. The article describes a clinical case of Lyell’s syndrome in an HIV-infected patient who was first prescribed ART in combination with valganciclovir. The diagnosis was made on the basis of characteristic clinical manifestations and the exclusion of another similar pathology. On the background of the therapy, the rash regressed, the areas of damaged skin became epithelialized, and the body temperature returned to normal. A differential diagnosis was made with measles, Stevens-Johnson syndrome, staphylococcal infection. Against the background of the therapy, the patient’s condition was positive.

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About the authors

Darya Popova

Peoples’ Friendship University of Russia (RUDN University); Moscow city clinical Infectious hospital 2 of the Department of health of Moscow city

Author for correspondence.
ORCID iD: 0000-0002-4056-9192
SPIN-code: 6196-2291

Russian Federation, 15, 8th Sokolinaya Gora street, Moscow


Sergey L. Voznesensky

Peoples’ Friendship University of Russia (RUDN University)

ORCID iD: 0000-0001-5669-1910
SPIN-code: 4487-6744

Russian Federation, Moscow

MD, Cand. Sci. (Med.), Associate Professor

Zinaida A. Soboleva

Moscow city clinical Infectious hospital 2 of the Department of health of Moscow city

ORCID iD: 0000-0002-1629-9348

Russian Federation, Moscow



  1. Esedov EM, Akhmedova FD, Akbieva DS. Toxic epidermal necrolysis in the practice of a family doctor. General practitioner reference book. 2020;(1):61–67. (In Russ). doi: 10.33920/med-10-2001-09
  2. Koudelka EN, Shakhmanov DM, Sobolev AF, et al. Toxic epidermal necrolysis (Lyell’s syndrome). Journal of Infectology. 2017;9(4):144–152. (In Russ). doi: 10.22625/2072-6732-2017-9-4-144-152
  3. Tezyaeva SA, Mlynnik RA, Degtyareva SF, et al. Lyell’s syndrome as a rare complication of drug therapy. Medial Magazine. 2015;(2):42–45. (In Russ).
  4. Hoffmann K, Rokstro YuK, ed. HIV 2014/2015. Medizin Fokus. Hamburg, Bonn; 2014. 924 р. (In Russ).
  5. Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T. Current perspectives on Stevens-Johnson Syndrome and toxic epidermal necrolysis. Clin Rev Allergy Immunol. 2018;54(1):147–176. doi: 10.1007/s12016-017-8654-z
  6. Tseng J, Maurer T, Mutizwa MM. HIV-associated toxic epidermal necrolysis at San Francisco General Hospital. J Int Assoc Provid AIDS Care. 2017;16(1):37–41. doi: 10.1177/2325957415614651
  7. French LE, Prins C. Erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis. In: Bolognia JL, Jorrizo JL, Schaffer JV, editors. Dermatology 3rd edition. New York: Elsevier; 2013. Р. 319–333. doi: 10.1002/9781444317633.ch76
  8. Chen P, Lin JJ, Lu CS. Carbamazepine-induced toxic effects and HLA-B*1502 screening in Taiwan. N Engl J Med. 2011;364(12):1126–1133. doi: 10.1056/NEJMoa1009717
  9. Hung SI, Chung WH, Liou LB. HLA-B5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol. Proc Natl Acad Sci USA. 2005;102(11):4134–4139. doi: 10.1073/pnas.0409500102
  10. Cartotto R, Mayich M, Nickerson D, Gomez M. SCORTEN accurately predicts mortality among toxic epidermal necrolysis patients treated in a burn center. J Burn Care Res. 2008;29(1):141–146. doi: 10.1097/BCR.0b013e31815f3865

Supplementary files

Supplementary Files Action
Fig. 1. Bullous changes in the skin with forging erosion.

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Fig. 2. Bullous skin changes with emerging erosion of the lower extremities.

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Fig. 3. Epithelialization of the erosive surface.

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Fig. 4. Epithelialization of the erosive surface of the lower extremities.

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