Related Experiment Video
Updated: Jan 16, 2026
07:22
A Standardized Procedure of Dressing Management for Toxic Epidermal Necrolysis
Published on: March 14, 2025
1.1K
Toxic epidermal necrolysis: lessons from three fatal cases.
Marko Demenj1, Vesna Reljić1,2, Emilija Manojlović Gačić2,3
1Dermatology Clinic, University Clinical Center of Serbia, Belgrade, Serbia.
Acta Dermatovenerologica Alpina, Pannonica, Et Adriatica
|September 27, 2025
Summary
Fatal cases of Toxic Epidermal Necrolysis (TEN) reveal diagnostic challenges and the impact of comorbidities. Treatment effectiveness, particularly with IVIg and managing underlying conditions, is crucial for survival in severe drug reactions.
Area of Science:
- Dermatology
- Pharmacovigilance
- Internal Medicine
Background:
- Toxic Epidermal Necrolysis (TEN) is a severe, life-threatening cutaneous adverse drug reaction.
- Early diagnosis and appropriate management are critical for patient outcomes.
- Factors influencing TEN mortality require further investigation.
Purpose of the Study:
- To analyze fatal cases of TEN, focusing on mortality determinants.
- To examine challenges in differential diagnosis, especially with Mycoplasma-induced rash and mucositis (MIRM).
- To evaluate the impact of comorbidities and treatment choices on TEN outcomes.
Main Methods:
- Retrospective case series analysis.
- Data collection from electronic medical records of hospitalized dermatology patients.
- Review of clinical manifestations, diagnoses, treatments, and complications.
Main Results:
- Three fatal TEN cases are presented, highlighting varied presentations and outcomes.
- Case 1: TEN misdiagnosed as MIRM, leading to fatal sepsis.
- Case 2: Ineffective low-dose IVIg in extensive TEN resulted in multiorgan failure.
- Case 3: Allopurinol-induced TEN with Balkan endemic nephropathy led to fatal renal failure.
Conclusions:
- Differentiating early TEN from MIRM poses diagnostic difficulties.
- High-dose IVIg is generally recommended; low-dose IVIg efficacy is inconsistent, especially with comorbidities.
- Preexisting conditions like renal disease significantly increase mortality risk in TEN patients.
More Related Videos
Related Concept Videos
01:26Toxic Reactions: Overview
1.8K
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,...
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,...
1.8K
01:16Necrosis
6.3K
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...
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...
6.3K
01:14Prevention of Further Absorption of Poison
1.2K
In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
1.2K
01:22Burn Injuries
4.2K
Burn injuries occur when the skin and underlying tissues are damaged due to exposure to heat, electricity, chemicals, radiation, or friction. They can vary in severity, from minor superficial burns to severe deep burns that can be life-threatening.
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
4.2K
01:19Clinical Applications of Epidermal Stem Cells
3.3K
Epidermal stem cells (EpiSCs) are mainly located at the basal layer of the epidermis. These cells repair minor injuries of the skin and replace dead skin cells. However, EpiSCs’ cannot heal severe wounds such as major burns or those from diabetes or hereditary disorders. In such cases, culturing the epidermal stem cells from the patient is possible and has yielded successful treatment options, such as laboratory-grown skin grafts. These grafts are synthesized using a patient’s own...
3.3K
01:36Types of Toxins
3.2K
Humans continually engage with an environment rich in potentially harmful chemicals. These are introduced to our bodies through inhalation, ingestion, or skin contact. These chemicals exist in various forms, such as air and environmental pollutants, agricultural chemicals, organic solvents, and heavy metals.
Air pollutants, primarily gases, pose significant threats to respiratory health, leading to conditions like hypoxia, lung cancer, and in extreme cases, death.
Environmental pollutants like...
Air pollutants, primarily gases, pose significant threats to respiratory health, leading to conditions like hypoxia, lung cancer, and in extreme cases, death.
Environmental pollutants like...
3.2K