Toxic epidermal necrolysis: A review

https://doi.org/10.1016/0190-9622(91)70176-3Get rights and content

This article reviews the many facets of toxic epidermal necrolysis. Emphasis is placed on the importance of early diagnosis, burn unit placement, supportive care, and avoidance of systemic steroids. Discussion also includes other therapeutic options and the pathophysiology of the disease.

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    • Toxic epidermal necrolysis: Part I. Introduction, history, classification, clinical features, systemic manifestations, etiology, and immunopathogenesis

      2013, Journal of the American Academy of Dermatology
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      As previously mentioned, there are a few exceptions in which “TEN without spots” exhibit >10% epidermal detachment on a large patch of erythema without preceding confluent purpuric macules or atypical flat target lesions. They most often begin with a prodrome of fever, malaise, anorexia, pharyngitis, headache, and rash, which may be morbilliform, defined as a fine, discrete maculopapular exanthem, or consist of atypical targetoid macules.16,32-35 Flaccid bullae, skin erosions, and painful inflammation and ulceration in the oral cavity comprise the major signs, which develop over a period of 1 day to 2 weeks33 (Fig 6).

    • Toxic epidermal necrolysis: Part II. Prognosis, sequelae, diagnosis, differential diagnosis, prevention, and treatment

      2013, Journal of the American Academy of Dermatology
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      −11.5 + (0.1 × patient’s age + 0.03 × total BSA involvement + 5.75 if sepsis is present). Patients surviving the acute phase of TEN are also at risk for a host of sequelae (Table II), ranging from skin scarring and eruptive melanocytic nevi to vulvovaginal stenosis and dyspareunia.13-19 Ocular lesions are the most common complication of TEN, described in 20% to 79% of patients,14,20-22 and include dry eye syndrome, photophobia, a sandy sensation in the eye, symblepharon, corneal scarring, corneal neovascularization, corneal xerosis, trichiasis, reduced visual acuity, blindness, and subconjunctival fibrosis (Fig 2).3,13,23-25

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