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Suggest Treatment For Toxic Epidermal Necrolysis
Question: My brother Aged 35 went through chemo therapy and radiation treatment for oral cancer. After radiation therapy he developed toxic epidermal necrolysis which could be a combination of radiation and Acyclovir tablets as per doctors. Over the 4 months periods except a small patch on the left side of neck as in photos, was treated with ceftum,wysolone for initial 10 to 12 days. Later woounder, siloderm,fucidin h,eumesone then again fucidin and now on soframycin for the last 1 month.skin in that particular junction point is very rough and the wound is not yet healed. What ointment should use for wound to heal quickly? What ointment should be used for clearing white patch and get normal skin?
Brief Answer:
Need for a pus culture
Detailed Answer:
Hi
I understand your concern regarding your brothers skin problem and I hope I am able to help you in the same.
Your brother seems to have developed an area of infected skin eczema which us but healing inspite of treatment with so many agents .
The best thing to do would be to get a pus culture and sensitivity done from the pus or discharge of the affected area .
This test will give us an idea about the organism which is causing this resistant infection and will also guide us regarding the drug or antibiotic which will be effective in its treatment .
So my advice would be to discuss this option with your treating doctor and get this test done from a nearby good lab .
Till that time ,I would suggest that you wash the affected area with a mild antiseptic lotion and apply an antibiotic cream twice daily .
As far as rest of the skin discoloration is concerned ,you need not worry since the skin colour will slowly revert back to normal at most of the places .
Dr Geetika Paul
Need for a pus culture
Detailed Answer:
Hi
I understand your concern regarding your brothers skin problem and I hope I am able to help you in the same.
Your brother seems to have developed an area of infected skin eczema which us but healing inspite of treatment with so many agents .
The best thing to do would be to get a pus culture and sensitivity done from the pus or discharge of the affected area .
This test will give us an idea about the organism which is causing this resistant infection and will also guide us regarding the drug or antibiotic which will be effective in its treatment .
So my advice would be to discuss this option with your treating doctor and get this test done from a nearby good lab .
Till that time ,I would suggest that you wash the affected area with a mild antiseptic lotion and apply an antibiotic cream twice daily .
As far as rest of the skin discoloration is concerned ,you need not worry since the skin colour will slowly revert back to normal at most of the places .
Dr Geetika Paul
Above answer was peer-reviewed by :
Dr. Yogesh D
Dear Madam,
Thanks for the response.Post radiation, he developed many issues on the eyes as well as tongue. We are in touch with eye specialist on the eyes treatment. He was on tube feeding from XXXXXXX till Sep end. After that the tube was removed and started taking liquid food.But he is not able to eat solid food and speak clearly due to the wound developed on the tongue.As we are not able to take photo of his tongue, attaching the sample image taken from net.Currently he is using mouth wash for 3-4 times a day to keep his oral health. We would like to know how to approach the treatment of tongue for faster cure.
Thanks for the response.Post radiation, he developed many issues on the eyes as well as tongue. We are in touch with eye specialist on the eyes treatment. He was on tube feeding from XXXXXXX till Sep end. After that the tube was removed and started taking liquid food.But he is not able to eat solid food and speak clearly due to the wound developed on the tongue.As we are not able to take photo of his tongue, attaching the sample image taken from net.Currently he is using mouth wash for 3-4 times a day to keep his oral health. We would like to know how to approach the treatment of tongue for faster cure.
Brief Answer:
Oral lesions take time to heal
Detailed Answer:
Hi
Oral lesions are a part of toxic epidermal necrolysis.
Oral lesions are usually the first one to develop and the last and the most difficult ones to heal .
The best thing to do is surely to maintain a good oral hygiene by doing antiseptic mouth gargles three to four hourly .
Since candida infections are mostly present in such cases,oral clotrimazole mouth paints are given to patients to be applied each time after mouth rinsing .
In some cases,patients are given oral anti fungal drugs and steroids one too for faster healing .
Although difficult,but it is important for the patient to eat healthy food and to avoid spicy and hot foods.
Dr Geetika Paul
Oral lesions take time to heal
Detailed Answer:
Hi
Oral lesions are a part of toxic epidermal necrolysis.
Oral lesions are usually the first one to develop and the last and the most difficult ones to heal .
The best thing to do is surely to maintain a good oral hygiene by doing antiseptic mouth gargles three to four hourly .
Since candida infections are mostly present in such cases,oral clotrimazole mouth paints are given to patients to be applied each time after mouth rinsing .
In some cases,patients are given oral anti fungal drugs and steroids one too for faster healing .
Although difficult,but it is important for the patient to eat healthy food and to avoid spicy and hot foods.
Dr Geetika Paul
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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