Introduction
Toxic epidermal necrolysis (TEN) is a severe and acute mucocutaneous reaction, typically caused by drugs, which results in the loss of epidermis and multi-site mucositis, accompanied by systemic disturbance. Lamotrigine, carbamazepine, allopurinol, sulfonamide antibiotics, and nevirapine are some of the most common drugs associated with TEN[1, 2]. Although there are numerous reports of drug-induced TEN, most of them focus on synthetic agents rather than herbal medications. In this report, we present a rare case of herbal medicine-induced toxic epidermal necrosis in a patient with hypergammaglobulinemic purpura of Waldenström (HGP).