Fatal Toxic Epidermal Necrolysis Associated With Cetuximab in a Patient With Colon Cancer

In 2006, a 74-year-old male patient with colon cancer and hepatic metastases developed fatal toxic epidermal necrolysis (TEN) after treatment with cetuximab, an epidermal growth factor receptor (EGFR) inhibitor. The patient had previously undergone chemotherapy without adverse reactions, but after receiving cetuximab from May to July 2006, he developed severe skin reactions that progressed to TEN, with over 70% epidermal detachment. Despite treatment with intravenous immunoglobulin and antibiotics for secondary infections, the patient succumbed to acute renal and respiratory failure. This case is significant as it is the first reported instance of fatal TEN associated with cetuximab, highlighting the need for clinicians to be aware of potential severe cutaneous adverse reactions to EGFR inhibitors, especially given the increasing use of cetuximab in colorectal cancer treatment.