1. Toxic Epidermal Necrolysis - Dermatology Health Guide Dermatology. toxic epidermal necrolysis. What is toxic epidermal necrolysis? What are the symptoms of toxic epidermal necrolysis? http://www.umm.edu/dermatology-info/toxic.htm

Dermatology Health Guide Anatomy of the Skin Skin Tests Describing a Skin Condition ... Glossary Related Resources Within UMM Dept. of Dermatology Dermatology Toxic Epidermal Necrolysis What is toxic epidermal necrolysis? Toxic epidermal necrolysis is a life-threatening skin disorder characterized by a blistering and peeling of the top layer of skin. This disorder can be caused by a drug reaction most often penicillin or another disease. About one-third of all diagnosed cases of toxic epidermal necrolysis are a result of unknown causes. What are the symptoms of toxic epidermal necrolysis? Toxic epidermal necrolysis can cause the skin to peel off in sheets, leaving large areas that look scalded. The loss of skin causes fluids and salts to ooze from the raw, damaged areas which can easily become infected. The following are the most common symptoms of toxic epidermal necrolysis. However, each person may experience symptoms differently: a painful, red area that spreads quickly the top layer of skin may peel without blistering scalded-looking raw areas of flesh discomfort fever condition spread to eyes, mouth, and genitals

2. EMedicine - Toxic Epidermal Necrolysis : Article By Victor Cohen, PharmD Alan Lyell provided an early description of toxic epidermal necrolysis (TEN) in 1956. Lyell described TEN as Avakian R, Flowers FP, Araujo OE toxic epidermal necrolysis a review http://www.emedicine.com/med/topic2291.htm

(advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Medicine, Ob/Gyn, Psychiatry, and Surgery Infectious Diseases Toxic Epidermal Necrolysis Last Updated: July 30, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: acute disseminated epidermal necrosis, acute skin failure, Lyell syndrome, TEN, Stevens-Johnson syndrome, SJS-TEN AUTHOR INFORMATION Section 1 of 11 Author Information Introduction Clinical Differentials ... Bibliography Author: Victor Cohen, PharmD , Clinical Coordinator, Department of Emergency Medicine, Maimonides Medical Center, Assistant Professor, Division of Pharmacy Practice, Schwartz College of Pharmacy and Health Sciences Coauthor(s): Robert A Schwartz, MD, MPH , Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School Victor Cohen, PharmD, is a member of the following medical societies: American Association of Colleges of Pharmacy American College of Clinical Pharmacy American Society of Health-System Pharmacists , and Society of Critical Care Medicine Editor(s): Fred A Lopez, MD

3. Postgraduate Medicine: Pearls In Dermatology PEARLS IN DERMATOLOGY. toxic epidermal necrolysis. A widespread, lifethreatening blistering reaction A diagnosis of toxic epidermal necrolysis induced by TMP-SMZ was made http://www.postgradmed.com/issues/2000/04_00/brodell.htm

PEARLS IN DERMATOLOGY Toxic epidermal necrolysis A widespread, life-threatening blistering reaction Paul Watanakunakorn, MD; Robert T. Brodell, MD VOL 107 / NO 4 / APRIL 2000 / POSTGRADUATE MEDICINE A n 18-year-old woman had a 3-day history of skin tenderness over her entire body and blistering involving 40% of her body surface area, including face, trunk, upper arms, and thighs. Mucosal tissues, including lips, throat, conjunctivae, and labia, were tender and eroded (figure 1). One week before onset of symptoms, she had been treated with trimethoprim-sulfamethoxazole (TMP-SMZ) for a urinary tract infection. A diagnosis of toxic epidermal necrolysis induced by TMP-SMZ was made. The patient was admitted to a burn unit and carefully handled to prevent further tissue sloughing. Treatment consisted of administration of fluids to achieve balance, nutritional support, oral prednisone (60 mg per day for 4 days), and local application of mupirocin ointment. The patient's condition stabilized over 2 weeks, and she was discharged. Figure 1. Denuded skin with flaccid blisters over the cheeks, neck, and chest of 18-year-old patient with toxic epidermal necrolysis. Lips are eroded and erythematous. Dermal-epidermal separation (below the pigmented layer of epidermis) is evidenced by lighter shade of exposed dermis on chest in contrast to darker tan of surrounding skin.

4. Dermatology - Toxic Epidermal Necrolysis toxic epidermal necrolysis. What is toxic epidermal necrolysis? toxic epidermal necrolysis is a lifethreatening skin disorder characterized by a blistering and peeling of the skin. all diagnosed http://www.muschealth.com/derm/toxic.htm

Toxic Epidermal Necrolysis What is toxic epidermal necrolysis? Toxic epidermal necrolysis is a life-threatening skin disorder characterized by a blistering and peeling of the skin. This disorder can be caused by a drug reaction - frequently antibiotics or anticonvulsives. About one-third of all diagnosed cases of toxic epidermal necrolysis do not have an identifiable cause. What are the symptoms of toxic epidermal necrolysis? Toxic epidermal necrolysis causes the skin to peel in sheets, leaving large, raw areas exposed. The loss of skin allows fluids and salts to ooze from the raw, damaged areas and can easily become infected. The following are the other most common symptoms of toxic epidermal necrolysis. However, each individual may experience symptoms differently. Symptoms may include: a painful, red area that spreads quickly the skin may peel without blistering raw areas of skin discomfort fever condition spread to eyes, mouth, and genitals The symptoms of toxic epidermal necrolysis may resemble other skin conditions. Always consult your physician for a diagnosis.

5. Erythema Multiforme toxic epidermal necrolysis (TEN) is distinguished by larger body surface area involvement, and the treatment of erythema multiforme or toxic epidermal necrolysis. There have been no http://www.bcm.tmc.edu/oto/grand/22092.html

Grand Rounds Archives The information contained within the Grand Rounds Archive is intended for use by doctors and other health care professionals. These documents were prepared by resident physicians for presentation and discussion at a conference held at The Baylor College of Medicine in Houston, Texas. No guarantees are made with respect to accuracy or timeliness of this material. This material should not be used as a basis for treatment decisions, and is not a substitute for professional consultation and/or peer-reviewed medical literature. ERYTHEMA MULTIFORME AND TOXIC EPIDERMAL NECROLYSIS Michael G. Stewart, MD February 20, 1992 Clinical Features The diagnostic criteria for erythema multiforme (EM) is individual "target" skin lesions less than 3 cm in diameter, less than 20% of body surface area involved, with minimal mucous membrane involvement, and biopsy compatible with EM. The cutaneous lesions are typically symmetric, and involve the extremities, with the dorsal hands and extensor aspects most commonly involved. Many authors use the designation erythema multiforme minor and major, with EM minor meaning skin lesions only, and EM major being synonymous with Stevens-Johnson syndrome.

6. Acute Pulmonary Manifestations Of Toxic Epidermal Necrolysis pulmonary manifestations associated with toxic epidermal necrolysis (TEN) are not well Pulmonary complications in toxic epidermal necrolysis a prospective clinical study http://www.journalofburns.com/read.php?articlerow=50

7. Stevens Johnson Syndrome Foundation Nonprofit organization dedicated to providing information and support to persons afflicted with Stevens Johnson Syndrome and toxic epidermal necrolysis. http://www.stevensjohnsonsyndrome.net

8. EMedicine - Toxic Epidermal Necrolysis : Article By Robert Fan, MD Infectious Diseases. toxic epidermal necrolysis. Last Updated August 10, 2001 Background toxic epidermal necrolysis (TEN) is a severe mucocutaneous exfoliative disease with an http://www.emedicine.com/emerg/topic599.htm

(advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Emergency Medicine Infectious Diseases Toxic Epidermal Necrolysis Last Updated: August 10, 2001 Rate this Article Email to a Colleague Synonyms and related keywords: TEN, mucocutaneous exfoliative disease, staphylococcal scalded skin syndrome, SSSS AUTHOR INFORMATION Section 1 of 9 Author Information Introduction Clinical Differentials ... Bibliography Author: Robert Fan, MD , Attending Staff, Department of Emergency Medicine, Kaiser Permanente Medical Center at Hayward Coauthor(s): Peter Viccellio, MD , Vice-Chair, Professor, Department of Emergency Medicine, State University of New York at Stony Brook Editor(s): Theodore Gaeta, DO, MPH , Residency Director, Clinical Associate Professor of Emergency Medicine in Medicine, Department of Emergency Medicine, New York Methodist Hospital; Francisco Talavera, PharmD, PhD , Senior Pharmacy Editor, Pharmacy, eMedicine; Mark L Plaster, MD, JD

9. Toxic Epidermal Necrolysis - A Medical Reference Article toxic epidermal necrolysis. A Center. A resource with information on over 10,000 medical topics including toxic epidermal necrolysis. http://www.umm.edu/dwp/007267.htm

Toxic epidermal necrolysis A Medical Article provided by University of Maryland Medical Center A resource with information on over 10,000 medical topics including: Toxic epidermal necrolysis Previous Next

10. EMedicine - Toxic Epidermal Necrolysis : Article By Robert Fan, MD toxic epidermal necrolysis toxic epidermal necrolysis (TEN) is a severe mucocutaneous exfoliative disease with an uncertain pathogenesis and a high mortality http://www.emedicine.com/EMERG/topic599.htm

(advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Emergency Medicine Infectious Diseases Toxic Epidermal Necrolysis Last Updated: August 10, 2001 Rate this Article Email to a Colleague Synonyms and related keywords: TEN, mucocutaneous exfoliative disease, staphylococcal scalded skin syndrome, SSSS AUTHOR INFORMATION Section 1 of 9 Author Information Introduction Clinical Differentials ... Bibliography Author: Robert Fan, MD , Attending Staff, Department of Emergency Medicine, Kaiser Permanente Medical Center at Hayward Coauthor(s): Peter Viccellio, MD , Vice-Chair, Professor, Department of Emergency Medicine, State University of New York at Stony Brook Editor(s): Theodore Gaeta, DO, MPH , Residency Director, Clinical Associate Professor of Emergency Medicine in Medicine, Department of Emergency Medicine, New York Methodist Hospital; Francisco Talavera, PharmD, PhD , Senior Pharmacy Editor, Pharmacy, eMedicine; Mark L Plaster, MD, JD

11. Toxic Epidermal Necrolysis – Patient Information toxic epidermal necrolysis – information for patients. NZ toxic epidermal necrolysis. What is toxic epidermal necrolysis? Toxic http://www.dermnetnz.org/pre/dna.erythema.multiform/ten.html

12. THE MERCK MANUAL, Sec. 10, Ch. 118, Inflammatory Reactions Drug Eruptions. toxic epidermal necrolysis. Erythema Multiforme peels off in sheets, leaving widespread denuded areas. toxic epidermal necrolysis (TEN) most often occurs in adults http://www.merck.com/pubs/mmanual/section10/chapter118/118c.htm

This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 10. Dermatologic Disorders Chapter 118. Inflammatory Reactions Topics [General] Drug Eruptions Toxic Epidermal Necrolysis Erythema Multiforme ... Granuloma Annulare Toxic Epidermal Necrolysis A life-threatening skin disease in which the epidermis peels off in sheets, leaving widespread denuded areas. Toxic epidermal necrolysis (TEN) most often occurs in adults. Sulfonamides, barbiturates, NSAIDs, phenytoin, allopurinol, and penicillin are most frequently associated, but numerous other drugs have been less commonly implicated. Intake of drugs is denied by about 1/5 of patients. In about 1/3 of cases, the cause is unclear because of concomitant serious disease and drug treatment. TEN is one of the few true dermatologic emergencies; the mortality rate is 61%. Symptoms and Signs TEN typically begins with painful localized erythema that disseminates rapidly. At the sites of erythema, flaccid blisters occur or the epidermis peels off in large sheets with gentle touching or pulling (Nikolsky's sign). Malaise, chills, myalgias, and fever accompany the denudation. Widespread areas of erosion, including all mucous membranes (eyes, mouth, genitalia), occur within 24 to 72 h, and the patient may become gravely ill. Affected areas of skin often resemble second-degree burns. Death is caused by fluid and electrolyte imbalance and multiorgan sequelae (eg, pneumonia, GI bleeding, glomerulonephritis, hepatitis, infection). Diagnosis

13. Toxic Epidermal Necrolysis. DermNet NZ toxic epidermal necrolysis information for patients. NZ necrolysis. toxic epidermal necrolysis. What is toxic epidermal necrolysis? http://www.dermnetnz.org/dna.erythema.multiform/ten.html

@import url("/common/screen.css"); DermNet NZ Ad Authoritative facts about the skin from the New Zealand Dermatological Society Home For patients For doctors ... Site map Search: Home Reactions Toxic epidermal necrolysis What is toxic epidermal necrolysis? Toxic epidermal necrolysis (TEN) is luckily very rare as it is often fatal. It is characterised by blistering and peeling of the top layer of skin. The lesion resembles that of a severe burn and needs to be distinguished from staphylococcal scalded skin syndrome , which has a similar appearance but the blister arises nearer to the skin surface. A skin biopsy is often necessary to distinguish these two diseases. It is thought to be related to a severe form of erythema multiforme , Stevens-Johnson syndrome. What causes toxic epidermal necrolysis? TEN is most often caused by an adverse reaction to a drug, but it sometimes arises in patients who are not taking any medications. Non-drug causes include bacterial or viral infection, malignant tumours, vaccinations or no apparent cause (idiopathic). Drugs that are known to cause TEN include: Antibiotics Sulphonamides Penicillins Macrolides Quinolones Allopurinol Nonsteroidal anti-inflammatory drugs (NSAIDs) Anticonvulsants (antiepileptic medicines) Who is at risk of toxic epidermal necrolysis?

14. THE MERCK MANUALSECOND HOME EDITION, Stevens-Johnson Syndrome StevensJohnson Syndrome and toxic epidermal necrolysis. In toxic epidermal necrolysis, large areas of skin peel off, often with just a gentle touch or pull. http://www.merck.com/mrkshared/mmanual_home2/sec18/ch203/ch203e.jsp

15. A Decade Of TEN: An Update On Toxic Epidermal Necrolysis A decade of TEN An update on toxic epidermal necrolysis. NS Huq, J Sproat Key WordsEtiology, Morbidity, Mortality, Treatment, toxic epidermal necrolysis. Order Full TextFor a http://www.pulsus.com/PLASTICS/04_03/huq__ed.htm

forgot your password? Papers and Articles 1996, Volume 4, Number 3: A decade of TEN: An update on toxic epidermal necrolysis NS Huq, J Sproat A review of the Hamilton experience over a 10-year period, discussing treatment trends, etiology and outcomes is presented. Key Words: Etiology, Morbidity, Mortality, Treatment, Toxic epidermal necrolysis Order Full Text -For a nominal fee order online and receive a copy of this article either by email, fax or mail Pdf Format - Registered users can view the complete article in Pdf format. REGISTERED USERS LOGIN REGISTER NOW!

16. THE MERCK MANUAL, Sec. 10, Ch. 118, Inflammatory Reactions Erythema Nodosum. Granuloma Annulare. click here for navigation help. toxic epidermal necrolysis. toxic epidermal necrolysis (TEN) most often occurs in adults. http://www.merck.com/mrkshared/mmanual/section10/chapter118/118c.jsp

17. Toxic Epidermal Necrolysis . Causes and symptoms. Diagnosis. Treatment. Prognosis. Prevention. Key Terms. Resources. Definition toxic epidermal necrolysis is a rare condition that causes large portions of the epidermis toxic epidermal necrolysis (TEN) begins with fever, cough, and other nonspecific symptoms......toxic epidermal necrolysis. Definition. http://www.ehendrick.com/healthy/001376.htm

MAIN SEARCH INDEX Toxic epidermal necrolysis Definition Description Causes and symptoms Diagnosis ... Resources Definition Toxic epidermal necrolysis is a rare condition that causes large portions of the epidermis, the skin's outermost layer, to detach from the layers of skin below. A reaction to a medication is the primary cause. Description Toxic epidermal necrolysis (TEN) begins with fever cough , and other nonspecific symptoms, and is soon followed by purplish, bloody-looking lesions on the skin and mucous membranes. These early lesions, typically found on the head, neck, and upper chest, soon merge and blister. Sheets of epidermis then begin to detach from the skin layers below. In time, the entire surface of the skin may be involved, with detachment of 100% of the epidermis. Causes and symptoms The main cause of TEN is a severe drug reaction. Some investigators believe there may be additional infectious causes. A severe reaction in transplant patients, called graft-vs.-host disease , can also produce TEN. One study reported more than 100 different drugs as causes of TEN. The drugs most commonly implicated, however, include antibacterial sulfonamides such as sulfadiazine

18. Toxic Epidermal Necrolysis MAIN SEARCH INDEX. toxic epidermal necrolysis. Advances in toxic epidermal necrolysis. Seminars in Cutaneous Medicine and Surgery 15 (Dec. 1996) 258266. http://www.ehendrick.org/healthy/001376.htm

MAIN SEARCH INDEX Toxic epidermal necrolysis Definition Description Causes and symptoms Diagnosis ... Resources Definition Toxic epidermal necrolysis is a rare condition that causes large portions of the epidermis, the skin's outermost layer, to detach from the layers of skin below. A reaction to a medication is the primary cause. Description Toxic epidermal necrolysis (TEN) begins with fever cough , and other nonspecific symptoms, and is soon followed by purplish, bloody-looking lesions on the skin and mucous membranes. These early lesions, typically found on the head, neck, and upper chest, soon merge and blister. Sheets of epidermis then begin to detach from the skin layers below. In time, the entire surface of the skin may be involved, with detachment of 100% of the epidermis. Causes and symptoms The main cause of TEN is a severe drug reaction. Some investigators believe there may be additional infectious causes. A severe reaction in transplant patients, called graft-vs.-host disease , can also produce TEN. One study reported more than 100 different drugs as causes of TEN. The drugs most commonly implicated, however, include antibacterial sulfonamides such as sulfadiazine

19. UAB Health System | Toxic Epidermal Necrolysis toxic epidermal necrolysis. What is toxic epidermal necrolysis? toxic epidermal necrolysis is a lifethreatening skin disorder characterized http://www.health.uab.edu/show.asp?durki=20796

20. Toxic Epidermal Necrolysis toxic epidermal necrolysis. Definition. Advances in toxic epidermal necrolysis. Seminars in Cutaneous Medicine and Surgery 15 (Dec. 1996) 258266. http://www.healthatoz.com/healthatoz/Atoz/ency/toxic_epidermal_necrolysis.html

Encyclopedia Index T Home Encyclopedia Encyclopedia Index T Toxic epidermal necrolysis Definition Toxic epidermal necrolysis is a rare condition that causes large portions of the epidermis, the skin's outermost layer, to detach from the layers of skin below. A reaction to a medication is the primary cause. Description Toxic epidermal necrolysis (TEN) begins with fever cough , and other nonspecific symptoms, and is soon followed by purplish, bloody-looking lesions on the skin and mucous membranes. These early lesions, typically found on the head, neck, and upper chest, soon merge and blister. Sheets of epidermis then begin to detach from the skin layers below. In time, the entire surface of the skin may be involved, with detachment of 100% of the epidermis. Causes and symptoms The main cause of TEN is a severe drug reaction. Some investigators believe there may be additional infectious causes. A severe reaction in transplant patients, called graft-vs.-host disease , can also produce TEN. One study reported more than 100 different drugs as causes of TEN. The drugs most commonly implicated, however, include antibacterial sulfonamides such as sulfadiazine

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