title: Toxic epidermal necrolysis: the experience of Coimbra's burn unit.
abstract: BACKGROUND
  Toxic Epidermal Necrolysis is a drug-induced life-threatening systemic disease, characterized by extensive dermoepidermal detachment and mucositis. At least 95% of cases are believed to be drug-induced. SCORTEN is a scoring system used to stratify severity and predict mortality. Treatment demands immediate withdrawal of the causative drug and early transfer to a burn centre for specific and intensive care.
  
  
  METHODS
  Authors have performed a retrospective study of 21 consecutive patients with SJS/ Toxic Epidermal Necrolysis admitted in the Burn Centre of Coimbra's University Hospital, between January 1999 and December 2010, and have compared the actual mortality rate with that predicted by SCORTEN, in order to assess the predictive capacity of SCORTEN. Analysis of results and treatment options were conducted. Data were analysed in SPSS 17.0®.
  
  
  RESULTS
  Thirteen females (61.9%) and 8 males (38.1%) were treated, mean age 55.6 ± 23.7 years and with a mean of 51% ± 22.4% epidermal detachment. The overall observed mortality rate was 47.6% and the one predicted by SCORTEN 42.2%. Immediate withdrawal of the causative drug and early transfer of the patient to our burn centre were the basis of treatment.
  
  
  CONCLUSIONS
  Toxic Epidermal Necrolysis pathophysiology remains to be clarified and no specific treatment has unequivocally proven to be effective. SCORTEN seems to be an accurate scoring system for estimation of mortality rate.
authors.affiliation: Serviço de Cirurgia Plástica e Queimados. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.. cslpinheiro@gmail.com.
authors.forename: Susana
authors.initials: S
authors.lastname: Pinheiro
authors.forename: Ricardo
authors.initials: R
authors.lastname: Carvalho
authors.forename: Sara
authors.initials: S
authors.lastname: Ramos
authors.forename: Carla
authors.initials: C
authors.lastname: Diogo
authors.forename: Marisa
authors.initials: M
authors.lastname: Caetano
authors.forename: Luís
authors.initials: L
authors.lastname: Cabral
authors.forename: Celso
authors.initials: C
authors.lastname: Cruzeiro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002053:Burn Units; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal; D012189:Retrospective Studies; D013262:Stevens-Johnson Syndrome / Q000628:therapy*; D055815:Young Adult