Toxic epidermal necrolysis
Toxic Epidermal Necrolysis
Welcome to the Toxic epidermal necrolysis subsection of the Dermatology for the MSRA course.
This section is designed to provide comprehensive and structured learning materials to help you understand and master the topic of Toxic epidermal necrolysis for the MSRA.
Toxic epidermal necrolysis (TEN) is a rare but life-threatening dermatological emergency characterised by widespread skin detachment. This section provides essential information to help understand and manage this condition effectively.
Resources for Toxic Epidermal Necrolysis:
- Toxic Epidermal Necrolysis Revision Notes for MSRA:
Detailed and concise traditional revision notes covering all essential aspects of Toxic epidermal necrolysis, including its causes, symptoms, diagnosis, and treatment. These notes follow UK NICE guidelines and are displayed in a table format for easy recall. - Toxic Epidermal Necrolysis Flashcards for MSRA:
Interactive flashcards to help you memorise key facts and concepts about Toxic epidermal necrolysis. Perfect for quick reviews and reinforcing your knowledge. - Toxic Epidermal Necrolysis Accordion Q&A Notes for the MSRA:
A unique feature where you can test your understanding of Toxic epidermal necrolysis with question-and-answer style revision notes. This format promotes active learning and retention of important information. - Toxic Epidermal Necrolysis Rapid Fire Quiz for MSRA:
A short quiz designed to test your knowledge and recall of Toxic epidermal necrolysis concepts. This is a great way to assess your progress and pinpoint areas needing further review.
Key Points about Toxic Epidermal Necrolysis
- Definition: Toxic epidermal necrolysis (TEN) is a severe, life-threatening skin condition characterised by widespread skin detachment and mucosal involvement, typically caused by a drug reaction. It is closely related to Stevens-Johnson syndrome (SJS), but involves more than 30% of the body surface area.
- Causes: The most common cause is an adverse reaction to medications, including antibiotics (e.g., sulphonamides), anticonvulsants (e.g., lamotrigine, carbamazepine), nonsteroidal anti-inflammatory drugs (NSAIDs), and allopurinol.
- Symptoms: Early symptoms include flu-like symptoms such as fever, malaise, and sore throat. This is followed by painful erythematous patches that progress to widespread skin detachment, leaving large, raw areas prone to infection. Mucosal involvement is common, affecting the eyes, mouth, and genitals.
- Investigations: Diagnosis is clinical, but a skin biopsy is essential to confirm the diagnosis and distinguish it from other blistering skin conditions. Blood tests, such as liver function and kidney function tests, may help to monitor organ involvement.
- Management: Immediate discontinuation of the offending drug is crucial. Supportive care in a burns or intensive care unit is often necessary, including fluid and electrolyte replacement, wound care, and infection prevention. Some patients may benefit from immunosuppressive treatments like intravenous immunoglobulin (IVIG) or cyclosporine.
- Complications: Complications include infection (sepsis), multi-organ failure, scarring, vision loss, and death. Mortality rates for TEN are high, particularly in older adults and those with extensive skin involvement.
We encourage you to use these resources for optimal revision and explore other related topics for a thorough preparation.
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