• Meina Lv, Shaojun Jiang, Jinglan Fu, Yuxin Liu, Siheng Lian, and Jinhua Zhang.
• Department of Pharmacy, Fujian Medical University Union Hospital.
• Medicine (Baltimore). 2021 Jan 22; 100 (3): e24392.

RationaleToxic epidermal necrolysis (TEN) is a rare, severe mucosal response of the skin associated with a high mortality rate. TEN is most commonly caused by drugs, and is characterized by extensive skin epidermal exfoliation.Patient ConcernsA 68-year-old woman presented with a rash that had persisted for four days. The patient who had undergone a mitral valve replacement 1 month prior and was taking atorvastatin at the time of admission.DiagnosesThe patient exhibited more than 30% exfoliation surfaces and the severe drug eruption was considered to be TEN. According to human leukocyte antigen (HLA) allele detection and ALDEN score, HLA alleles which found in this case report may be an cause of TEN induced by atorvastatin.InterventionsAll drugs used prior to admission were discontinued and the patient was given antiallergic drugs.OutcomesAfter 3 weeks following Antiallergic treatment, the rash on patient's calf had subsided, the edema was relieved, and the patient was no longer experiencing pain. After 60 days following discharge, the patient's skin has regrown.LessonsThis is the first report describing the induction of TEN by atorvastatin in a HLA alleles carrier. For HLA alleles carrier, atorvastatin may need to be used with caution to avoid TEN. Future systematic research is also required to confirm this finding and avoid similar serious skin adverse reactions.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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