A 70 year old male patient had successively received bicalutamide, abiraterone combined with goserelin endocrine therapy and docetaxel neoadjuvant therapy for prostate cancer. The relevant indicators were regular reviewed, suggesting disease progression. On July 20, 2022, he began to take apatamide 240 mg orally once a day. After 30 days, the patient developed purple-red rashes, multiple erosions and blister rashes,  and gradually progressed to large-area epidermal exfoliation. Considering apalutamide-related toxic epidermal necrolysis, he was given drug withdrawal, anti-allergy, anti-infection and immunoglobulin shock treatment. The rash gradually improved around 4 weeks. This case suggests that the clinical use of apatamide should be alert to the possibility of related toxic epidermal necrolysis, and the patient 's medication education should be done at the same time. Once a suspicious adverse reaction occurs, the drug should be stopped immediately and disposed in time.

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