ArticleFrontiers in allergy2026
Treatment of toxic epidermal necrolysis in a patient with extensive skin damage induced by dimethyl N-cyanodithioiminocarbonate: a case report.
Article in Frontiers in allergy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Dimethyl N-cyanodithioiminocarbonate is a sulfur-containing industrial compound known to induce severe cutaneous reactions, including toxic epidermal necrolysis (TEN). Current management primarily focuses on immunomodulation, yet there is a recognized gap in standardized wound and systemic care for extensive, sepsis-complicated cases. This report describes a rarely documented case of dimethyl N-cyanodithioiminocarbonate-induced TEN involving over 90% of the total body surface area (TBSA) complicated by wound sepsis, and represents the application of a major-burn treatment protocol for this specific chemical-induced condition. Case presentation: A 43-year-old male chemical plant worker presented with rapidly progressing skin detachment covering 92% TBSA and mucosal involvement, following occupational exposure without adequate protection. After initial dermatological management failed to prevent clinical deterioration, he was transferred to a burn intensive care unit (BICU). A multidisciplinary burn-oriented strategy was implemented, including: precise fluid resuscitation, gradual tapering of systemic corticosteroids, use of an air-fluidized bed, topical nano-silver dressings with compound purple grass oil, targeted antibiotics, and intensive nutritional support. Within two weeks, complete re-epithelialization was achieved without surgical intervention, and all infection markers normalized. Conclusions: The integration of burn-critical care principles-particularly structured fluid resuscitation, pressure-offloading, and moist wound management-into the treatment of severe chemical-induced TEN can facilitate rapid wound closure and systemic recovery even in high-mortality-risk cases. This case supports the adoption of a multidisciplinary, burn-informed approach for extensive TEN and underscores the need for heightened occupational safety measures when handling potent sensitizers such as dimethyl N-cyanodithioiminocarbonate.
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