Toxic epidermal necrolysis

Toxic epidermal necrolysis (TEN) is an acute life-threatening skin disease with commonly quoted overall risk of mortality of between 25 and 30%, though the risk of fatal outcome is around 90% in the most severely affected patients (SCORTEN score >5). It is characterised by the rapid onset of extensive erythema, necrosis, and bullous detachment of the epidermis (> 30% body surface area). Commonly, the mucous membranes are also involved. Death may result from a combination of sepsis, fluid depletion and multi-organ failure. In two thirds of cases, TEN is triggered by a clearly identifiable drug allergy.