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Nekrolisis epidermal toksik (NET) merupakan reaksi mukokutan akut dan episodik yang mengancam jiwa, ditandai epidermolisis serta kelainan pada selaput lendir di orifisium dan mata. Angka kematian berkisar antara 5 – 50%. Penyebab paling sering adalah penggunaan obat. Terapi kortikosteroid masih kontroversi. Imunoglobulin intravena merupakan pengobatan suportif yang mempunyai efek menghambat apoptosis berlebihan.

Seorang perempuan 20 tahun dengan nekrolisis epidermal toksik yang diduga akibat amoksisilin atau parasetamol. Komplikasi yang terjadi yaitu simblefaron, pneumonia, dan infeksi saluran kemih. Terapi awal dengan kortikosteroid dan antibiotik sistemik memberikan hasil yang kurang memuaskan. Kemudian diberikan tambahan terapi adjuvan imunoglobulin intravena dengan dosis 4 x 2.5 g (50 ml) perhari selama 5 hari dengan hasil yang baik.

Kortikosteroid dan antibiotik pada kasus ini tidak memberikan hasil yang memuaskan sehingga diberikan terapi adjuvan imunoglobulin intravena. Imunoglobulin mengandung antibodi melawan Fas, menghambat ikatan FasL dengan Fas sehingga tidak terjadi apoptosis yang berlebihan. Terapi imunoglobulin pada kasus ini memberikan hasil yang baik.

Kata kunci : nekrolisis epidermal toksik,  imunoglobulin intravena, fas

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Toxic Epidermal Necrolysis (TEN) is an acute mucocutaneous reaction with an episodic of life-threatening, marked by epidermolisis disorder the mucous membrane of all orificium and eyes. The mortality rates are between 5 – 50%. The most often cause was medicine. Corticosteroid therapy is still controversial. Intravenous immunoglobulin is supportive treatment that has the effect of blocking excessive apoptosis.

A 20-year-old, female with TEN suspected after taking amoxycillin or paracetamol. The complications that occurred are simblefaron, pneumonia, and urinary tract infection. Early treatment with corticosteroid and antibiotic systemic were unsatisfactory. After additional treatment with intravenous of 2.5 g (50 ml) immunoglobulin QID for 5 consecutive days gave a good results.

Corticosteroid and antibiotic in this case did not give satisfactory result, but the patient gained a good result after intravenous immunoglobulin administration. Immunoglobulins contain antibodies against Fas that are able to block the binding of FasL to Fas to prevent from excessive apoptosis. Immunoglobulin treatment in this case gave a satisfactory result.

Key words: toxic epidermal necrolysis, intravenous immunoglobulin, fas