Deciphering Supportive Treatment Strategies for Toxic Epidermal Necrolysis

Serge      Jennes; Gerald      E. Pierard; Philippe      Paquet

Abstract

Toxic epidermal necrolysis (TEN) is a dreadful life-threatening syndrome typically induced by an adverse drug reaction. This condition is characterized by the sudden and extensive destruction of the epidermis. The patient should be promptly addressed to a burn unit where three types of treatment should be administered, namely, (a) specific topical care of the bullous/eroded skin areas, (b) systemic anti-apoptotic/necrotic treatments, and (c) supportive care preventing secondary internal organ failures. This latter aspect is covered by the present review and focuses on (a) early withdrawal of the causative drug, (b) airway management, (c) hydro-electrolytic control, (d) nutritional support, (e) antibiotherapy, (f) prevention of venous thrombosis and gastroduodenal ulcers, and (g) analgesia and anesthesia.

Keywords: Drug reaction, toxic epidermal necrolysis, burn, epidermis, bullous, apoptotic, necrotic, eroded, causative, antibiotherapy