Lyell´s syndrome provoked by external drug use

Lyell´s syndrome is rare. Up to 10 cases are registered per million population per year. The mortality rate for Lyell’s syndrome is 5–12%.

Two patients were observed aged, respectively, 38 years and 72 years with Lyell’s syndrome. The disease manifested itself against the background of local application of drugs. In one case ― Doloben’s gel as an analgesic at the site of a bruise of the right hand. In another case, a 20% solution of chlorohxidin biogluconate as a mouth rinse for stomatitis. The first symptoms of the disease occurred locally at the site of application of these medicines. In the first case, the skin of the right hand, in the second ― the mucous membrane of the mouth. The outcome of the disease depended on early diagnosis, urgent hospitalization in a specialized department, from the area of skin lesions, the appointment of adequate therapy.

Lyell’s syndrome can occur at any age, and the risk of developing the disease increases in those over the age of 40. In the elderly, SL in terms of the first symptoms and rate of disease progression, the nature of skin and mucous membrane lesions does not have any fundamental differences with those in younger patients. The distinctive features and risk factors of Lyell’s syndrome in the elderly include, firstly, its occurrence against the background of the already formed comorbid age-related pathology of internal organs, secondly, the concomitant age-related pathology during the development of an acute toxic-allergic reaction is decompensated, a multiorgan failure is formed, which is the cause of more severe Lyell’s syndrome and higher mortality. In young people, a comorbid viral infection can be considered a risk factor, especially the combination of HIV-infection and chronic hepatitis C.