Advances in toxic epidermal necrolysis.
On the basis of the clinicopathologic and causative characteristics, one can separate an erythema multiformis spectrum from a toxic epidermal necrolysis (TEN)-Stevens Johnson syndrome which is a drug induced disease. Despite a well-known clinical aspect, several cutaneous diseases may be mistaken for TEN. Responsible drugs are sulfonamides anticonvulsants, and nonsteroidal antiinflammatory drugs--patients infected with HIV are at a higher risk of developing TEN. Pathogenesis includes abnormal drug metabolism and cell mediated immune keratinocyte apoptosis. Treatment relies on symptomatic management and so-called specific treatments including steroids are probably harmful.
Revuz
J E
JE
Service de Dermatologie, Hôpital Henri Mondor, Université Paris XII, Créteil, France.
Roujeau
J C
JC
D003937:Diagnosis, Differential; D006801:Humans; D011379:Prognosis; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy