Toxic epidermal necrolysis clinical guidelines

TEN is a rare but severe exfoliating skin disease caused primarily by medication reactions. Ideal management should consist of stopping the offending drug, intensive supportive care, and rapid transfer to a burn unit. Diagnosis by punch biopsy may be useful, and the SCORTEN score may be helpful in prognosis. Wound management consists of debridement of sloughed epidermis and wound coverage with an appropriate biological or long-term dressing. Corticosteroids and empiric antibiotics are not recommended. The use of IVIG or plasmapheresis cannot be strongly recommended based on available evidence. The importance of close long-term outpatient follow-up cannot be overstated. Copyright © 2008 by the American Burn Association.