Nécrolyse épidermique toxique. Revue des cas observés dans le service de réanimation du centre national hospitalier et universitaire de Cotonou

Abstract

Introduction. – Toxic epidermal necrolysis (TEN) is usually a drug-induced disease, involving vital or functional prognosis with 20 to 30% mortality rates. Objectives. – The aim was to collect cases of TEN in an intensive care unit in Cotonou National University and Teaching Hospital, and describe epidemiologic, clinical, therapeutic and evolutive patterns. Study design. – Retrospective and descriptive study over five years. Patients and methods. – The medical report–forms of patients admitted between January 1998 and December 2002, for toxic dermatitis with total skin injury area more than 10% were reviewed. Results. – Fourteen patients with TEN were identified. The average incidence was three cases per year, accounting for 0.25% of the admissions in the unit. Sulphonamides ( n = 4), antituberculous drugs ( n = 2), penicillin ( n = 3) were the main cause of TEN. In five patients, the cause was not found. Self-medication was found in 7 patients. Total skin injury area reached from 26 to 87%. Mucosal and viscera injury occurred in respectively 11 and 9 patients. The treatment was usual as in extended burns. Four patients died (28.5%). The average time before hospitalisation was 11.4 days. Conclusion. – The growing-awareness of people can prevent/reduce the morbidity and improve the prognosis of TEN.