title: Management of Toxic Epidermal Necrolysis with Plasmapheresis and Cyclosporine A: Our 10 Years' Experience.
abstract: BACKGROUND
  The management of toxic epidermal necrolysis (TEN) is controversial and there is no uniform strategy.
  
  
  OBJECTIVE
  To share our 10 years' experience in treating severe TEN with a novel protocol based on the association of cyclosporine A and plasmapheresis.
  
  
  METHODS
  In this case series, we retrospectively collected and assessed the 12 cases of severe TEN treated from 2005 to 2015 at the Burn Unit of the University of Bari Policlinico hospital.
  
  
  RESULTS
  Average body surface area was 77; average SCORETEN was 4.3. The 12 patients had been treated with culprit drug withdrawal, systemic corticosteroids, and/or cyclosporine A with no response. The protocol was successfully administered in all 12 cases. Average time to response from protocol start was 4.9 days. Average time to remission from protocol start was 22 days; average hospital stay at our unit was 24.8 days. Four patients developed severe complications; 1 patient died. No complications linked to the protocol therapeutic measures were observed. The relatively small number of cases given the rarity of the condition is a limitation of this report.
  
  
  CONCLUSIONS
  Our protocol based on the association of cyclosporine A and plasmapheresis is safe and efficacious in treating severe TEN.
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari 70124, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giudice
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari 70124, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Maggio
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari 70124, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Bufano
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari 70124, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Memeo
authors.affiliation: Unit of Plastic and Reconstructive Surgery, Department of Emergency and Organ Transplantation, University of Bari, Bari 70124, Italy.
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Vestita