Toxic epidermal necrolysis is a life-threatening dermatological emergency with high mortality if not treated in time. Here we report a case of
toxic epidermal necrolysis due to
carbamazepine in rural Nepal in
COVID-19 pandemic who was successfully treated with the help of mobile teledermatology. The clinical impression of
toxic epidermal necrolysis was made from "WhatsApp" video calls using a smart phone. The supportive features were the history of starting of
carbamazepine 2 weeks prior for
seizure disorder, clinical findings in serial photographs of skin with 40 percent body surface area involvement of necrotic skin lesions and
bulla, and involvement of oral mucosa and eyes. The patient was immediately asked to stop
carbamazepine and was treated with intravenous fluids and systemic
steroids along with symptomatic management. As the whole world was suffering from lockdown due to
COVID-19 crisis, it was impossible for the rural area patient to visit a dermatologist. Thus, with the help of paramedics staff in a community health center and mobile teledermatology, the patient was diagnosed as
carbamazepine-induced
toxic epidermal necrolysis and treated successfully with good outcome.