TOXIC EPIDERMAL NECROLYSIS (TEN)

It is a drug reaction whereby the skin is peeling off from all over the body. Epidermal cells keratinocytes which hold the skin to the body are dying out (necrosis), hence the peeling off.

Some consider TEN to be a more severe form of Stevens-Johnson Syndrome.

There is an initial week of fever before red rash and skin peeling.

Most affected are the epithelia covering the mouth, eyes, and vagina where there are blisters, crusts, and ulceration.

Treatment is to remove the offending drug, place patient in burn unit or intensive care, and intravenous immunoglobulin.