Skip to main content

Toxic Epidermal Necrolysis

James R. Yon, MD and Anna M Malysz Oyola, DO Reviewed 05/2023
 


BASICS

Toxic Epidermal Necrolysis is an acute life-threatening mucocutaneous disease caused by a severe T-cell–mediated immunologic reaction resulting in extensive epidermal detachment requiring immed...

DIAGNOSIS

HISTORY

  • Onset is typically 1 to 3 weeks after initiation of drug.

  • Prodrome of fever, malaise, headache, sore throat, and conjunctivitis followed by skin lesions after 1 to 3 days (detailed bel...

TREATMENT

  • Most important medical management requires 1) early recognition of diagnosis, 2) withdrawal of offending drug agent, and 3) supportive care.

  • Early transfer to an ICU/burn unit is critical bec...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Avoidance of inciting drug or drug class in the future

  • Monitoring of dermatologic and ocular sequelae

PROGNOSIS

  • Skin reepithelialization usually occurs within 1 to 3...

REFERENCES

1
Schwartz  RA, McDonough  PH, Lee  BW. Toxic epidermal necrolysis: part I. Introduction, history, classification, clinical features, systemic manifestations, etiolog...

ADDITIONAL READING

  • Abe  R. Immunological response in Stevens-Johnson syndrome and toxic epidermal necrolysis. J Dermatol.  2015;42(1):42–48. [View Abstract on OvidMedli...

CODES

ICD10

L51.2 Toxic epidermal necrolysis [Lyell] 

SNOMED

  • 23067006 Lyell’s toxic epidermal necrolysis, subepidermal type (disorder)

  • 402744003 toxic epidermal necrolysis due to drug (disorder)

  • 403214005 ...

CLINICAL PEARLS

  • SJS and TEN are on a spectrum, with TEN the more severe disease.

  • Expert care in burn centers improves outcomes.

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×