Toxic Epidermal Necrolysis: A Review of Past and Present Therapeutic Approaches

Skin Therapy Lett. 2022 Sep;27(5):7-13.

Abstract

Toxic epidermal necrolysis (TEN) is an immune mediated, severe cutaneous adverse drug reaction characterized by epidermal detachment affecting greater than 30% body surface area. The mortality rate of TEN exceeds 20% and is usually caused by infection and respiratory compromise. Withdrawal of the causative drug, supportive care, and adjuvant therapy improve prognosis. Over the past decade, randomized controlled trials and meta-analyses have supported a role for cyclosporine, tumor necrosis factor alpha inhibitors, and combination therapy with intravenous immune globulin and corticosteroids. This review summarizes the medical management of TEN in adult patients.

Keywords: IVIG; SJS; Stevens-Johnson syndrome; TEN; corticosteroids; cyclosporine; etanercept; intravenous immunoglobulin; toxic epidermal necrolysis.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Cyclosporine / therapeutic use
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / therapeutic use
  • Stevens-Johnson Syndrome* / drug therapy
  • Stevens-Johnson Syndrome* / etiology

Substances

  • Immunoglobulins, Intravenous
  • Cyclosporine
  • Adrenal Cortex Hormones
  • Immunologic Factors