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Updated: Jul 14, 2026

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
Published on: March 14, 2025
Toxic epidermal necrolysis: 15 years' experience in a Dutch burns centre
B Gerdts1, A F P M Vloemans, R W Kreis
1Rode Kruis Ziekenhuis, Burns Centre, Department of Surgery, Beverwijk, The Netherlands. B.Gerdts@chello.nl
Background:
Toxic epidermal necrolysis (TEN) is a severe and potentially fatal drug reaction characterized by an extensive skin rash with blisters and exfoliation, frequently accompanied by mucositis. The wounds caused by TEN are similar to second-degree burns and severe cases may involve large areas of skin loss.
Objectives:
Analysis of our results in patients with TEN and evaluation of the variety of therapeutic interventions that has been studied and suggested in TEN.
Patients/Methods:
Retrospective analysis of 19 consecutive patients with TEN treated in our burns centre between 1989 and 2004.
Results:
Immediate withdrawal of any potentially fatal drug, maximum supportive care, and a restricted and tailored antibiotic, medical and surgical treatment regimen confined mortality to 21%, whereas prognosis scores like APACHE II and SCORTEN predicted mortality of 22 and 30%, respectively. A positive contribution of selective digestive decontamination is suggested but has yet to be established.
Conclusions:
Because of a potentially fatal outcome, fast referral of a patient suspected of TEN to a specialized centre (mostly a burns unit or specialized dermatology centre) for expert wound management and tailored comprehensive care is strongly advised and contributes to survival.
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