TOXIC EPIDERMAL NECROLYSIS

Background. Most studies on drug-induced toxic epidermal necrolysis (T EN) report a high mortality rate. This has been attributed partly to t he use of corticosteroids for its treatment. However, we consider cort icosteroids to be the sheet anchor for saving the patients having TEN. Materials and Methods. Our approach to the treatment of this disease consists of administering a relatively high dose of corticosteroids to control the reaction at the earliest possible time and then withdrawi ng corticosteroids at the fastest possible rate. Results. As illustrat ed by the five case reports, the reaction is controlled within 24 to 4 8 hours and the corticosteroids are withdrawn within the next 7 to 10 days. During this period, the skin also shows almost complete healing. With the confidence gained with this approach, we undertake the provo cation test as a rule in every patient to find the actual drug respons ible for the reaction. Conclusions. Corticosteroids used in an appropr iate dosage schedule constitute an important component of the treatmen t for TEN to ensure early recovery.