Definition of Toxic Epidermal Necrolysis (TEN)

Reviewed on 9/1/2022

Toxic epidermal necrolysis (TEN) is a potentially life-threatening disorder that produces widespread blistering and peeling of the skin. TEN is most commonly induced by a drug (for example, an antibiotic or other medication), but other triggers occasionally cause TEN (triggers like an infection or a malignancy). With severe TEN, occasionally the barrier and containment properties of the skin are dangerously compromised and the patient's condition resembles that of a burn patient.

Early treatment involves identifying the trigger or causative drug or agent and removing or keeping the compound away from the patient. Hospitalization is recommended; for severe TEN, a burn unit is suggested. Other treatments may include the following:

  • IV fluids, carefully monitor
  • Protective bandages especially where the skin has peeled off
  • Ointments
  • Pain control
  • Antibiotics or antivirals
  • IV immunoglobulin G
  • Anticonvulsants
Jameson, J. Larry, et al. Harrison's Principles of Internal Medicine, 20th Ed. New York: McGraw-Hill Education, 2018.

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