PMC8358493_01
(A) Dark erythema and papules scattered across the patient's torso. (B) The Nikolsky phenomenon observed on the left lower back and abdomen. (C) Blood clots on the lips, and oral mucosal erosion. (D) Pathological examination using hematoxylin-eosin staining showing subepidermal blistering, extensive keratinocyte necrosis, and lymphocytic infiltration near the basal epidermal layer, and perivascular inflammatory cell infiltration with mild lymphocytes in the shallow dermis.
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PMC8358493_01_10.1177_23247096211037462-fig1.jpg
fig1-23247096211037462
Adverse Events version 4.0. Although prednisolone (1 mg/kg) and acyclovir were administered, under suspicion for irAE and herpes zoster, respectively, which we had started for GBS on day 5 of hospitalization, the patient developed dark erythema and scattered papules on his torso (Figure 1A) on day 9. Subsequently, blisters and erosions appeared on 18% of his body surface area with Nikolsky phenomenon (Figure1B), blood clots on the lips, and oral mucosal erosion (Figure 1C). Pathological examination via hematoxylin-eosin staining revealed subepidermal blistering, extensive keratinocyte necrosis, and lymphocytic infiltration near the basal layer of the epidermis, and perivascular inflammatory cell infiltration with mild lymphocytes in the shallow dermis (Figure 1D); and the patient was diagnosed with SJS/TEN overlap.