Mingang Zhu,1 Yin Wang,1 Sheng Wei,1 Guang Chen,2 Er-Min Gu3 

1Department of Dermatology, The First People’s Hospital of Jiashan, Jiashan Hospital Affiliated of Jiaxing University, Jiaxing, 314100, People’s Republic of China; 2Department of Pathogenic Biology and Immunology, School of Medicine, Taizhou University, Taizhou, 318000, People’s Republic of China; 3Department of Pharmacy, The First People’s Hospital of Jiashan, Jiashan Hospital Affiliated of Jiaxing University, Jiaxing, 314100, People’s Republic of China

Correspondence: Guang Chen, Email misschenguang75@163.com Er-Min Gu, Fax +86 57384289731, Email ermingu@163.com

Abstract: Toxic epidermal necrolysis (TEN) is a rare and low incidence rate disease characterized by pirfenidone-induced skin damage. Pirfenidone is a new anti-fibrotic and anti-inflammatory drug that can alleviate the deterioration of lung function in patients with COVID-19-induced pneumonia and prolong the progression-free survival period. However, side effects of pirfenidone have drawn widespread attention, which include gastrointestinal symptoms, liver damage, skin photosensitivity, and rash. So far, many cases caused by pirfenidone have been reported. As far as we know, cases of TEN induced by pirfenidone have rarely been reported. This article presents cases of TEN induced by pirfenidone, so that clinicians can be aware of the possibility of TEN when using pirfenidone, and how to use inflammation-relevant indicators for evaluating the severity and risk of death of TEN, which has potential clinical value.

Keywords: toxic epidermal necrolysis, pirfenidone, inflammation relevant indicators, clinical value