Case report: Toxic epidermal necrolysis induced by tislelizumab in a patient with esophageal squamous cell carcinoma

Background: Immune checkpoint inhibitors (ICIs) have been widely applicated for the treatment of patients with advanced esophageal cancer. Skin-related adverse reactions are frequent with ICIs, with toxic epidermal necrolysis (TEN) being a severe and potentially life-threatening cutaneous reaction.

Case presentation: We present a case of a 70-year-old male with locally advanced esophageal cancer who developed severe toxic epidermal necrolysis (TEN) after 18 days of tislelizumab combined with chemotherapy. The condition rapidly progressed to cover approximately 90% of his body. After treatment with intravenous methylprednisolone, immunoglobulin, and antibiotics, along with active nutritional support and wound care, the patient recovered from TEN induced by tislelizumab.

Conclusion: Treatment for TEN is complex, and no standardized guidelines currently exist. We propose an economical, safe, effective, and simple strategy for similar TEN patients.