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Related Concept Videos

Drug Toxicity: Allergic Reactions01:30

Drug Toxicity: Allergic Reactions

Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial exposure to a...
Toxic Reactions: Overview01:26

Toxic Reactions: Overview

When toxic substances penetrate the human body, they disseminate to various tissues, undergoing metabolic changes. This process yields reactive metabolites that may covalently bind with specific target molecules, resulting in toxicity.
Toxicity falls into two primary categories: local and systemic.
Local toxicity appears at the exposure site, such as protein denaturation caused by caustic substances.
In contrast, systemic toxicity requires the toxic agent's absorption and distribution,...
Necrosis01:16

Necrosis

Necrosis is considered as an “accidental” or unexpected form of cell death that ends in cell lysis. The first noticeable mention of “necrosis” was in 1859 when Rudolf Virchow used this term to describe advanced tissue breakdown in his compilation titled “Cell Pathology”.
Morphological Manifestations of Necrosis
Necrotic cells show different types of morphological appearance depending on the type of tissue and infection. In coagulative necrosis, cells become anucleated and die, but their...
Diphtheria01:28

Diphtheria

Diphtheria is an acute, toxin-mediated infectious disease that primarily affects the upper respiratory tract. It is caused by Corynebacterium diphtheriae, a Gram-positive, pleomorphic rod that lacks spore-forming capability and exhibits a characteristic club-shaped morphology under microscopic examination. While C. diphtheriae can asymptomatically colonize mucosal surfaces, clinical disease manifests only when the bacterial strain is lysogenized by a specific β-corynephage. This phage...
Drug Toxicity: Dose-Dependent Reactions01:24

Drug Toxicity: Dose-Dependent Reactions

Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
Cellular Injury IV: Necrosis01:16

Cellular Injury IV: Necrosis

Necrosis is a form of irreversible cell death caused by severe injury such as ischemia, toxins, or trauma. Unlike programmed cell death, it is an uncontrolled, pathological process that typically provokes inflammation in surrounding tissues.Pathophysiologic ChangesNecrosis begins when cells sustain critical damage, leading to swelling of organelles, particularly mitochondria, and rapid ATP depletion. As energy levels decline, membrane ion pumps fail, leading to calcium influx and eventually,...

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Updated: May 7, 2026

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
07:22

A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis

Published on: March 14, 2025

Rapidly developing toxic epidermal necrolysis.

Viktoria Oline Barrios Poulsen1, Jonas Nielsen, Troels Dirch Poulsen

  • 1Department of Anesthesia and Intensive Care Medicine, Copenhagen University Hospital, Roskilde Køgevej 7-13, 4000 Roskilde, Denmark.

Case Reports in Emergency Medicine
|September 27, 2013
PubMed
Summary
This summary is machine-generated.

Severe drug reactions like Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) require prompt treatment. This case highlights successful intensive care management for a severe TEN patient with multi-organ failure.

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A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
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Published on: August 7, 2018

Area of Science:

  • Dermatology
  • Intensive Care Medicine
  • Pharmacology

Background:

  • Severe cutaneous reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), are rare but have high mortality rates.
  • Drug-induced reactions are the most common cause, necessitating urgent intervention for favorable outcomes.
  • Current treatment guidelines are lacking, with many approaches based on limited evidence.

Purpose of the Study:

  • To report a case of severe drug-induced toxic epidermal necrolysis (TEN) with multi-organ failure.
  • To illustrate the successful application of intensive care and specialized treatments in a high-mortality risk patient.
  • To emphasize the importance of prompt recognition and management in severe cutaneous adverse drug reactions.

Main Methods:

  • A 54-year-old male patient with 30% total body surface area (TBSA) detachment due to drug-induced TEN and a high SCORTEN score (>90% mortality) was managed.
  • The patient received sedation, mechanical ventilation, circulatory support, and component therapy guided by thromboelastography (TEG).
  • Interventions included plasmapheresis, shock reversal, transfer to a specialized burn intensive care unit, and hemodialysis.

Main Results:

  • The patient's pulmonary, circulatory, and renal functions improved with intensive care.
  • Re-epithelialization occurred slowly, and the patient was discharged on hospital day 19.
  • Despite a critical condition (SCORTEN=5), multi-organ failure was successfully managed, leading to patient survival.

Conclusions:

  • Prompt recognition, withdrawal of the offending drug, and rapid, intensive multi-system support are crucial for managing severe drug-induced TEN.
  • Specialized intensive care, including burn unit management and therapies like plasmapheresis and hemodialysis, can improve outcomes in critically ill patients.
  • This case underscores the potential for survival even in patients with severe TEN and significant organ dysfunction when aggressive and evidence-guided treatment is applied.