Toxic Epidermal Necrolysis

Abstract

Toxic Epidermal Necrolysis (TEN) syndrome is an uncommon, acute, life-threatening, medication related disorder. It is a condition that is characterized by full thickness epidermal necrosis. It involves sloughing of the skin at the dermal-epidermal junction with epidermal detachment. TEN occurs when lesions occupy greater then 30% of the total body surface area. A review of the patients diagnosed and treated for TEN in the last five years at Buddhist Tzu-Chi General Hospital was undertaken. A total of 8 patients with TEN were treated between Jan. 1998 and Dec. 2003. There were 6 males and 2 females. The mean age of the patients was 56 years (range 27-74). The mean TBSA involved was 44%. Six patients had multiple co-morbid illnesses. Three patients were treated in the Burn ICU. Four patients were treated with steroids. Two patients developed sepsis and both died. TEN is a rare and severe disease, associated with a high mortality rate. Early, timely diagnosis as well as prompt critical care treatment with nutritional support, intravenous fluids and treatment in a burn ICU setting is beneficial in decreasing the mortality, morbidity and hospital stay.