PMC9813861_01
Photographs of skin lesion induced by sintilimab in an elderly patient with relapsed thymic carcinoma. (A) Rashes after first cycle of treatment. (B, C) Rashes with blisters and skin detachment after second cycle of treatment. (D) Skin after recovery from severe toxic epidermal necrolysis.
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After the second cycle, there was recurrence of rash on the face, trunk, and the extremities, which aggravated with formation of blisters and skin detachment ( Figures 1A-C ). One month later, the rash disappeared ( Figure 1D ), but the pneumonia worsened.
Biopsy of the skin lesion showing detachment of the epidermis and mucous membrane, which confirmed toxic epidermal necrolysis. Black arrow indicates subepidermal blisters. White arrow indicates perivascular lymphocytes accumulation.
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The patient underwent biopsy of skin lesion; pathological staining showed detachment of the epidermis and mucous membrane, which was confirmed as toxic epidermal necrolysis (TEN,  Figure 2 ).
Timeline of diagnosis and major interventions. Body weight of this patient was 55 kg.
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Timeline of diagnosis and major interventions is shown in  Figure 3 .