Toxic epidermal necrolysis

Toxic epidermal necrolysis, often called TEN, is a rare but very serious skin reaction that is almost always triggered by medications. It causes widespread death and shedding of the top layer of skin, similar to a severe burn. TEN is considered a medical emergency and requires immediate hospital care, usually in a burn unit or intensive care unit. The condition typically begins one to three weeks after starting a new medication. Early signs include fever, flu-like symptoms, and a painful rash that quickly spreads across the body. The skin develops blisters and begins to peel off in large sheets, leaving raw, exposed areas underneath. The eyes, mouth, throat, and genital areas are also commonly affected. Because the skin acts as the body's protective barrier, losing large areas of it puts patients at serious risk for infection, dehydration, and organ failure. TEN is defined as skin detachment affecting more than 30 percent of the body surface area. When less than 10 percent is affected, it is called Stevens-Johnson syndrome (SJS), and between 10 and 30 percent is called SJS-TEN overlap. The most common medications that trigger TEN include certain antibiotics (like sulfonamides), anti-seizure drugs (like carbamazepine, phenytoin, and lamotrigine), allopurinol (used for gout), and some nonsteroidal anti-inflammatory drugs. Treatment focuses on stopping the offending drug immediately, providing intensive supportive care including wound management, fluid replacement, pain control, and preventing infections. Some doctors may use immunosuppressive treatments, though their benefit is still debated.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Bring these to your next appointment

• Q1.Which specific medication caused my TEN, and what related drugs should I also avoid for life?,Should I get HLA genetic testing to understand my risk with other medications?,What long-term complications should I watch for, especially with my eyes?,Should my family members be tested for the same genetic risk factors before taking certain medications?,How can I safely take medications in the future, and should I see a pharmacologist?,What mental health support is available to help me cope with this experience?,How do I get a medical alert bracelet or card, and what information should it include?

Common questions about Toxic epidermal necrolysis

Related conditions

Other rare diseases commonly researched alongside Toxic epidermal necrolysis.

• Staphylococcal scalded skin syndrome→