Toxic epidermal necrolysis and clarithromycin.

Toxic epidermal necrolysis almost always occurs after taking a medication. Despite spectacular clinical signs, it is mainly diagnosed with pathologic techniques. The identification of a drug as the cause for the immune related cytotoxic reaction can be difficult if the molecule is not generally known to be a classical cause of this reaction. The present study describes a female patient who rapidly developed a severe bullous skin disease after taking clarithromycin for tonsillitis. The case illustrates the process involved in attributing causality to a molecule using an established imputability assessment framework.