Ocular manifestations of toxic epidermal necrolysis associated with allopurinol use
T. O. Bennett, J. Sugar and S. Sahgal
A 54-year-old man was receiving allopurinol therapy to treat hyperuricemia
that followed an inferior wall, myocardial infarction. After three weeks of
allopurinol therapy, the patient developed signs and symptoms of toxic
epidermal necrolysis that included pseudomembranous conjunctivitis with
ulcerative lesions on the lids and conjunctiva, and punctate corneal
staining with subsequent corneal abrasions. Treatment with topical
antibiotics and artificial tears relieved the symptoms somewhat, but
punctate staining and dry eyes persisted after 14 months of follow-up.
Bilateral corneal ulcers developed and necessitated conjunctival flaps in
each eye. Visual acuity in each eye was 20/40.