Toxic Epidermal Necrolysis

What is toxic epidermal necrolysis?

Toxic epidermal necrolysis is a life-threatening skin disorder characterized by a blistering and peeling of the skin. It can be caused by a reaction to medication, most often from antibiotics or anticonvulsives. The condition causes the skin to peel in sheets, leaving large raw areas.

  • If left untreated, the raw, damaged areas that result from the skin peeling away can easily become infected, and the condition can spread to the eyes, mouth, and genitals.
  • Toxic epidermal necrolysis progresses fast, usually within three days. For this reason, treatment usually includes hospitalization, often in the burn unit.
  • Toxic epidermal necrolysis can be caused by a reaction to medication, most often from antibiotics or anticonvulsives. Treatment may include the discontinuation of these medications.

What are the symptoms of toxic epidermal necrolysis?

Toxic epidermal necrolysis causes the skin to peel in sheets, leaving large raw areas. The loss of skin allows fluids and salts to ooze from the raw, damaged areas and can easily become infected.

Each child may experience symptoms differently, but the most common signs of toxic epidermal necrolysis are:

  • a painful, red area that spreads quickly
  • skin that may peel without blistering
  • raw areas of skin
  • discomfort
  • fever
  • spread of the condition to the eyes, mouth, and genitals

The symptoms of toxic epidermal necrolysis may resemble other skin conditions. Always consult your child's physician for a diagnosis.

How is toxic epiderman necrolysis treated?

Toxic epidermal necrolysis progresses fast, usually within three days. For this reason, treatment usually includes hospitalization, often in the burn unit. If a medication is causing the skin reaction, it is discontinued.

Treatment may include one, or several, of the following:

  • isolation to prevent infection
  • protective bandages
  • intravenous fluid and electrolytes
  • antibiotics
  • intravenous immunoglobulin G (IVIG)