Which medication is least likely to cause serious adverse effects in the context of toxic epidermal necrolysis?

In the context of toxic epidermal necrolysis (TEN), glucocorticoids such as prednisolone are often used with caution primarily to manage inflammation and prevent further skin damage. Although they have potential side effects, especially with long-term use, they are generally considered to have a lower association with the development of TEN compared to other medications that are more closely linked to this condition.

Antibiotics, anticonvulsants, and diuretics are commonly implicated in causing TEN and other serious skin reactions. For instance, ampicillin and carbamazepine have been recognized for their associations with severe cutaneous adverse reactions, including TEN. Hydrochlorothiazide can also lead to hypersensitivity reactions, although its incidence is not as high as with some anticonvulsants and antibiotics.

Prednisolone’s mechanism largely revolves around its ability to modulate immune responses rather than directly causing skin necrosis or serious epidermal reactions, making it the least likely to precipitate serious adverse effects in cases of TEN. Thus, in the context of managing or discussing medications involved with toxic epidermal necrolysis, prednisolone is viewed as the safer option.