Herbal medicine-induced toxic epidermal necrolysis in a 48-year old Filipino woman with invasive cervical cancer: a case report

Abstract

Toxic epidermal necrolysis (TEN) is a rare and severe dermatological emergency characterized by extensive necrosis and detachment of the epidermis, leading to significant mucous membrane erosions and severe systemic symptoms. While specific classes of conventional pharmaceuticals are identified as the primary cause of TEN, recent reports have implicated herbal medications as triggers. This case highlights a 48-year-old Filipino woman with invasive cervical cancer who developed TEN following the use of an herbal medication containing 23 botanical extracts. Despite immediate discontinuation of the herbal medication, the patient experienced rapid progression of vesicles and bullae to widespread epidermal detachment involving 90% of the body surface area. Histopathological examination confirmed the diagnosis of TEN. The patient was treated with systemic corticosteroids and supportive care, leading to a full recovery within 14 days. This case underscores the need for enhanced awareness among healthcare providers regarding the potential severe adverse drug reactions associated with herbal medicines and the necessity for stringent regulatory measures to ensure their safety. Moreover, underreporting of adverse events by both patients and healthcare professionals is due to a significant lack of awareness about the potential safety issues linked to herbal use. Therefore, enhanced education and strengthened regulatory policies are imperative to safeguard public health as the global use of herbal remedies and their associated adverse effects continue to rise.