Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2024; 12(7): 1290-1295
Published online Mar 6, 2024. doi: 10.12998/wjcc.v12.i7.1290
Efficacy of borneol-gypsum in skin regeneration and pain control in toxic epidermal necrolysis: A case report
Lu-Wei Yang, Li-Juan Zhang, Bin-Bin Zhou, Xin-Yu Lin, Yu-Ting Chen, Xiao-Yu Qin, Hui-Ying Tian, Li-Li Ma, Ying Sun, Lin-Di Jiang
Lu-Wei Yang, Li-Juan Zhang, Bin-Bin Zhou, Department of Rheumatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361100, Fujian Province, China
Xin-Yu Lin, Yu-Ting Chen, Department of Dermatology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361100, Fujian Province, China
Xiao-Yu Qin, Department of Ophthalmology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361100, Fujian Province, China
Hui-Ying Tian, Department of Nursing, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361100, Fujian Province, China
Li-Li Ma, Ying Sun, Lin-Di Jiang, Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai 200030, China
Author contributions: Yang LW participated in the clinical treatment of patients, performed the analysis, and wrote the manuscript, leading the main contributions to this work; Zhang LJ, Zhou BB, Lin XY, Chen YT, Qin XY, and Tian HY contributed equally to this work; Ma LL, Sun Y, and Jiang LD provided guidance for the work and analytical direction; All authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardians, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lin-Di Jiang, PhD, Chief Physician, Department of Rheumatology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200030, China. zsh-rheum@hotmail.com
Received: September 7, 2023
Peer-review started: September 7, 2023
First decision: December 7, 2023
Revised: December 18, 2023
Accepted: February 7, 2024
Article in press: February 7, 2024
Published online: March 6, 2024
Processing time: 175 Days and 13.7 Hours
Abstract
BACKGROUND

Toxic epidermal necrolysis (TEN) is a life-threatening dermatological emergency mainly induced by drug hypersensitivity reactions. Standard management includes discontinuation of culprit drug and application of immunomodulatory therapy. However, mortality remains high due to complications like septic shock and multiorgan failures. Innovative approaches for skin care are crucial. This report introduces borneol-gypsum, a traditional Chinese drug but a novel dressing serving as an adjuvant of TEN therapy, might significantly improve skin conditions and patient outcomes in TEN.

CASE SUMMARY

A 38-year-old woman diagnosed with eosinophilic granulomatosis with polyangiitis experienced gangrenous complications and motor nerve involvement. After initial treatment of high-dose corticosteroids and cyclophosphamide, symptom of foot drop improved, absolute eosinophil counts decreased, while limb pain sustained. Duloxetine was added to alleviate her symptom. Subsequently, TEN developed. Additional topical application of borneol-gypsum dressing not only protected the skin lesions from infection but also significantly eased localized pain. This approach demonstrated its merit in TEN management by promoting skin healing and potentially reducing infection risks.

CONCLUSION

Borneol-gypsum dressing is a promising adjuvant that could significantly improve TEN management, skin regeneration, and patient comfort.

Keywords: Toxic epidermal necrolysis; Eosinophilic granulomatosis with polyangiitis; Duloxetine; Borneol; Gypsum; Case report

Core Tip: This case report highlights the innovative use of Borneol-Gypsum dressing in the skin management of toxic epidermal necrolysis (TEN). Despite the standard treatments, the patient's condition improved remarkably after supplementary application of this dressing, showcasing its potential in halting disease progression and fostering skin regeneration. The borneol-gypsum dressing not only relieved pain of exfoliated skin but enhanced patient cooperation during dress changing, suggesting it could be a promising dermatological supplement for further care in TEN.