Toxic epidermal necrolysis

Synonym(s)

Acute disseminated epidermal necrosis; acute skin failure; Lyell syndrome

Definition

Severe, acute, systemic disorder characterized by extensive epidermal loss

Pathogenesis

Most often drug-induced (antiepileptic drugs, sulfonamides, ampicillin, allopurinol, nonsteroidal anti-inflammatory agents); immune-related cytotoxic reaction destroys keratinocytes; TNF-α likely main mediator in epidermal destruction directly through apoptosis, indirectly by stimulating cytotoxic T cells

Clinical manifestation

Prodrome of malaise, fever, cough, sore throat, myalgia, rhinitis, and anorexia;