Allergy Asthma Respir Dis AARD Allergy, Asthma & Respiratory Disease 2288-0402 2288-0410 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology 10.4168/aard.2016.4.4.301 Case Report Methazolamide-induced toxic epidermal necrolysis confirmed by lymphocyte activation test Han Kyu-Hyung 1 Hong Ku-Hyun 1 Kim Doh Hyung 1 Kim Youn Seup 1 Park Jae-Suk 1 Kim Seung-Heon 2 http://orcid.org/0000-0001-5800-8038 Jee Young-Koo 1 Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea. Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea. Correspondence to: Young-Koo Jee. Department of Internal Medicine, Dankook University College of Medicine, 119 Dandae-ro, Dongnam-gu, Cheonan 31116, Korea. Tel: +82-41-550-3923, Fax: +82-41-556-3256, ykjee@dankook.ac.kr 07 2016 31 07 2016 4 4 301 304 25 03 2016 19 05 2016 25 05 2016 © 2016 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology 2016 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).

Among various dermatological entities, toxic epidermal necrolysis (TEN) is a rare but potentially fatal delayed hypersensitivity reaction to numerous medications. A 38-year-old male presented with systemic hypersensitivity reaction, such as high fever, pain in the eyes, and diffuse pruritic erythematous maculopapular eruptions with multiple targetoid plaques that became vesicular and bullous. Oral mucosa and conjunctivae were involved. The first sign appeared about 1 week after taking methazolamide (50 mg twice a day) for the management of glaucomatous eyes. Although methazolamide was discontinued, blistering and skin denudation progressed to affect up to 80% of the body surface area and a positive Nikolsky sign was noted. High fever also persisted. Skin lesions started to improve after 2 weeks of management and fever subsided. Cutaneous lesions improved with minimal permanent sequele 2 months later. HLA-B*5901 was found by high-resolution genotyping. The lymphocyte activation test performed 6 months after remission showed a positive response to methazolamide challenge. This is the first case of methazolamide-induced TEN in which methazolamide was confirmed as a culprit drug by the lymphocyte activation test.

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