title: Toxic epidermal necrolysis: a retrospective analysis of 17 cases from central Tunisia.
abstract: Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a rare, life-threatening and wide-spread exfoliative disease of the skin and mucous membrane that is most commonly drug-induced. We retrospectively reviewed the charts of 17 patients who suffered from TEN in Farhat Hached University Hospital, Sousse, Tunisia over a 19-year period from January 1994 to January 2013. Causality for suspected drugs was assessed by means of the Naranjo adverse drug reaction (ADR) probability scale. Antibiotics, mainly ß-lactams, were the most common implicated drugs, followed by nonsteroidal anti-inflammatory drugs, anticonvulsants, and allopurinol. The interval between drug intake and onset of the first symptom ranged between few hours and 19 days with a mean period of 6.11 days. There was extensive skin detachment, averaging 66.17% of total body surface area (range 40-95%). The most major complication was infection, occurring in 9 patients (53%). Seven patients died with a mortality rate of 41%.
authors: Department of Clinical Pharmacology, Faculty of Medicine of Sousse, Tunisia.
authors: Chaker
authors: C
authors: Ben Salem
authors: Department of Clinical Pharmacology, Faculty of Medicine of Sousse, Tunisia.
authors: Atef
authors: A
authors: Badreddine
authors: Dermatology Ward, Farhat Hached University Hospital, Sousse, Tunisia.
authors: Omar
authors: O
authors: Belajouza
authors: Dermatology Ward, Farhat Hached University Hospital, Sousse, Tunisia.
authors: Colandane
authors: C
authors: Belajouza
authors: Dermatology Ward, Farhat Hached University Hospital, Sousse, Tunisia.
authors: Najet
authors: N
authors: Ghariani
authors: Medical Intensive Care, Medical Intensive Care Unit, Sahloul University Hospital, Sousse, Tunisia.
authors: Hmouda
authors: H
authors: Houssem
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007239:Infections / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013262:Stevens-Johnson Syndrome / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D013997:Time Factors; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult
keywords: Lyell′s syndrome; Toxic epidermal necrolysis; drug eruption