Toxic epidermal necrolysis in HIV-infected patients: are intravenous immunoglobulins really necessary in this subgroup?

The spectrum of Stevens-Johnson syndrome/toxic epidermal necrolysis (TEN) is the most severe form of cutaneous adverse reactions to drugs. We report a case of a HIV-positive man with TEN who presented a very good response to a single dose of intravenous immunoglobulins and a short pulse of corticosteroids, together with intensive supportive care. Although the largest study on the management of this type of patients reported to date suggests a scheme of three doses of intravenous immunoglobulins together with glucocorticoids, we implemented a single dose of immunoglobulins due to lack of availability.