TOXIC EPIDERMAL NECROLYSIS IN A BURNS-CENTER - A 6-YEAR REVIEW

Toxic epidermal necrolysis (TEN) is the most severe form of the Steven s-Johnson syndrome-toxic epidermal necrolysis (SJS-TEN) spectrum. It i s characterized by epidermal exfoliation and mucositis and carries an average mortality of 25 per cent. In this 6-year retrospective study, we reviewed 23 patients with drug-induced SJS-TEN. The most common cau sative agents were anticonvulsants and traditional medication. The mea n time of onset of symptoms was 4.1 days (range 1-16 days) and the mea n body surface area involved was 57.2 per cent (range 30-90 per cent). The condition was most commonly associated with ocular complications and sepsis. Using our treatment protocol in a burns centre, we were ab le to achieve a mean time to complete healing of 20.2 days (range 7-53 days) and a mean duration of hospitalization of 34.1 days (range 7-13 4 days). The length of hospital stay was prolonged when non-ocular com plications supervened. The percentage mortality in our series was 10 p er cent. It is our contention that the bet results are obtained with t reatment of the SJS-TEN patient in a burns centre with an internist, d ermatologist and infectious disease specialist as part of the manageme nt team. (C) 1996 Elsevier Science Ltd for ISBI.