title: Toxic epidermal necrolysis: 13 years of experience in the management at a Department of Dermatology in China.
abstract: OBJECTIVE
  The study aimed to investigate the efficacy of our therapeutic options on toxic epidermal necrolysis (TEN) patients.
  
  
  METHODS
  After giving informed consent, patients affected by TEN were included in the study between January 2001 and December 2013. Suspected causative drugs, onset to hospitalization, complications, management, outcome, laboratory investigations of blood tests and therapeutic options were recorded and analyzed. SCORTEN scoring system was used to evaluate the complications and the survival rate. Therapeutic interventions included immediate withdrawal of any potentially fatal drug, nursing care, supportive therapy, high-dose corticosteroids, antibiotics, plasma therapy, intravenous immunoglobulins (IVIG) and traditional Chinese medicine (TCM). Blood tests were taken as a result of clinical outcome.
  
  
  RESULTS
  Total 21 consecutive patients (10 males and 11 females, mean age 33 years) were included in the study. Cefalexin, paracetamol, quick cold capsules, compound aminopyrine phenacetin tablets, carbamazepine, propylthiouracil, sulfonamide, ampicillin, and phenylbutazone were suspected to be the causative agents. All patients received high-dose dexamethasone or methylprednisolone therapy. Eighteen patients received the administration of antibiotics. Twelve patients received plasma infusions, and 11 patients were given albumin. Only 2 patients applied IVIG. Additionally, 3 and 14 cases were intravenously injected with QKL and Xiyanping, respectively. The average score of SCORTEN was 2.52 and the average percentage of total body surface area was 68.8%. The mortality rate in our study was 19%.
  
  
  CONCLUSIONS
  The therapeutic options in our study, including nursing care, corticosteroid, anti-inflammatory and TCM are effective for the treatment of TEN.
authors.affiliation: a Department of Dermatology , The First Affiliated Hospital of Harbin Medical University , Harbin , PR China and.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
authors.affiliation: b Department of Hematology , The First Affiliated Hospital of Harbin Medical University , Harbin , PR China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002053:Burn Units; D002648:Child; D002675:Child, Preschool; D002681:China; D003880:Dermatology; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006748:Hospital Departments; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008516:Medicine, Chinese Traditional; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D003907:Dexamethasone; D008775:Methylprednisolone
keywords: Anti-inflammatory; clinical characteristics; laboratory investigations; toxic epidermal necrolysis; traditional Chinese medicine