RT Journal Article
SR Electronic
T1 Clinical Considerations for Epidermal Necrolysis
JF Ochsner Journal
JO Ochsner J
FD O. P. Jindal Global University
SP 413
OP 417
VO 14
IS 3
A1 Ellender, Ryan P.
A1 Peters, Cacey W.
A1 Albritton, Hannah L.
A1 Garcia, Andrew J.
A1 Kaye, Alan David
YR 2014
UL http://www.ochsnerjournal.org/content/14/3/413.abstract
AB Background Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered a spectrum of acute life-threatening mucocutaneous reactions that differ only in severity. Both diseases are characterized by mucous membrane and skin involvement, are often caused by medications, and are collectively known as epidermal necrolysis (EN).Methods A severity of illness score has been devised to predict prognosis in patients with EN. The scoring system addresses 7 prognostic factors.Results Patients with EN require supportive care. Those with extensive skin involvement should be admitted to an intensive care unit or burn unit if possible. Suspected, as well as unnecessary, medications should be discontinued. Baseline laboratory tests, imaging, cultures, and biopsies should be obtained. Intravenous access should be established and hydration and nutritional support begun. Daily oral care, wound care, pain control, and early physician consultation are also important aspects of treatment.Conclusion EN requires early diagnosis, appropriate workup, and appropriate treatment to minimize potential morbidity and mortality. In many clinicians' experience, EN is rare; therefore, education and improved understanding of the potential causes and appropriate treatment regimens are vital when confronted with such a patient.