Toxic epidermal necrolysis following oral omeprazole administration: A rare case report

Abstract: Toxic epidermal necrolysis (TEN) is one of the serious, life-threatening hypersensitivity reactions characterized by widespread epidermal necrosis and mucosal involvement, often triggered by medications. Although several high-risk drugs are known to cause TEN, proton pump inhibitors (PPIs) are rarely implicated. We present a case of TEN following the use of omeprazole by a male of 45 years with diabetes, who developed rapid-onset erythematous rash, blistering, and epidermal detachment (>30% body surface area) on the trunk, back, upper extremities, genital region as well on oral mucous membrane within hours of a intake of single dose (20 mg) omeprazole. Nikolsky’s was positive with SCORTEN severity score 3. This Adverse Drug Reaction was categorized as “Probable,” “Severe (Level 5),” and “Not Preventable.” The patient was managed with discontinuation of omeprazole and symptomatic treatment. Although PPIs are generally safe, they can cause severe hypersensitivity reactions, so eliciting history and giving an allergy card can help to prevent their occurrence.