Effective management of pembrolizumab-induced toxic epidermal necrolysis in a breast cancer patient using a silver foam dressing: A case report

Vijay Kumar, Aparna, Roopesh Ramesh, Alan Shaji, Abhishikha

22 December 2025

Chemoimmunotherapy is an effective treatment option for patients with breast cancer. However, it can be associated with adverse cutaneous side-effects, including toxic epidermal necrolysis (TEN), which can lead to significant morbidity and mortality. TEN is a severe and potentially fatal condition that requires prompt assessment and suitable intervention. In contemporary oncology, immunotherapy has become a cornerstone in managing various malignancies. This report details a case of TEN as an uncommon complication arising from the administration of pembrolizumab in conjunction with paclitaxel. Pembrolizumab is a humanised monoclonal antibody targeting programmed cell death-1 (anti-PD1) and is designed to inhibit tumours that express PDL-1. In our case report, the use of this monoclonal antibody for breast cancer treatment was discontinued due to the onset of this severe adverse reaction. Currently, there are no established guidelines for the optimal treatment of TEN, and reports on the effectiveness of steroids, intravenous immunoglobulin and dressings vary widely. The brief report highlights the importance of clinical awareness of the management of toxic epidermal necrolysis with a silver foam dressing.

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