Toxic Epidermal Necrolysis Induced by Diclofenac Sodium in a Dental Patient: A Case Report

Abstract

Diclofenac sodium is a widely prescribed non-steroidal anti-inflammatory drug in dental practice. Propionic acid derivatives and oxicams have been reported to be associated with erythema multiforme and Steven-Johnson syndrome. Here the authors present a rare case report of toxic epidermal necrolysis (TEN) induced by diclofenac sodium. The patient presented in dental clinic with toothache for which planned tooth extraction was done under antibiotic cover. Post extraction, patient was prescribed diclofenac sodium (50 mg b.i.d) for 3 days. The patient reported with generalized pruritic rashes with exfoliated skin to the extent of > 25%. Diclofenac was stopped promptly. The clinical condition of patient was monitored and multidisciplinary management was done to tackle emergency. No rechallenge was given. Although diclofenac sodium-induced TEN is a rare adverse effect, physicians and dentists must be careful prescribing diclofenac due to its life threatening adverse drug effect.

Keywords: Diclofenac, toxic epidermal necrolysis, adverse effects