title: Toxic epidermal necrolysis.
abstract: Toxic epidermal necrolysis (TEN) is a rare, life-threatening drug-induced skin disease with a mortality rate of approximately 30%. The clinical hallmark of TEN is a marked skin detachment caused by extensive keratinocyte cell death associated with mucosal involvement. The exact pathogenic mechanism of TEN is still uncertain. Recent advances in this field have led to the identification of several factors that might contribute to the induction of excessive apoptosis of keratinocytes. In addition, specific human leukocyte antigen types seem to be associated with certain drugs and the development of TEN. As well-controlled studies are lacking, patients are treated with various immunomodulators (e.g. intravenous immunoglobulin) in addition to the best supportive care.
authors.affiliation: Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Hoetzenecker
authors.affiliation: Medical Directorate, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: Tarun
authors.initials: T
authors.lastname: Mehra
authors.affiliation: Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland; Riga Stradins University, Riga, Latvia.
authors.forename: Ieva
authors.initials: I
authors.lastname: Saulite
authors.affiliation: Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Glatz
authors.affiliation: Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Schmid-Grendelmeier
authors.affiliation: Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: Emmanuella
authors.initials: E
authors.lastname: Guenova
authors.affiliation: Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cozzio
authors.affiliation: Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: Lars E
authors.initials: LE
authors.lastname: French
keywords: Stevens-Johnson syndrome; Toxic epidermal necrolysis; keratinocyte cell death; skin detachment