Friday, July 27, 2007

Derm: Toxic Epidermal Necrolysis

-MCC drugs (sulfonamides, anticonvulsants, pcns, nsaids, cephalosporins, allopurinol
-also infxns, immunizations, leukemia/lymphoma, connective tissue d/os
-mainly adults
-tender, red skin and mucosa, then blistering and desquamation
-flu-like prodrome before lesions by 1-14d
-usually starts face/upper body as macules and targets, then rapidly spread
-epidermis becomes necrotic and sloughs off in sheets, leaves behind dermis (cleavage at derm-epi jxn)
-can involve conjuctiva
-nikolsky + (like PV)
-death due to bact infxn and fluid loss
-steroids not recommended, no studies show benefit
-treat like burn




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