Toxic epidermal necrolysis in children--an update

Toxic epidermal necrolysis (TEN) is a relatively rare disease, characterized by generalized erythema, bulla formation, and exfoliation of the epidermis that resembles scalding. It is usually drug-induced and mediated by immune reactions of several types. TEN has to be differentiated from erythema multiforme and Stevens-Johnson syndrome. TEN bears a life-threatening potential and a risk for significant complications such as dehydration; secondary infections; pulmonary, gastrointestinal, and renal involvement; and late scarring with cosmetic and functional implications. Therapeutic interventions include admission in a burn center unit, systemic antibiotics and corticosteroids, topical therapy with antibacterial agents and biological dressings, and supportive measures.