Skin disorder symptoms and remedies: Toxic Epidermal Necrolysis
Toxic Epidermal Necrolysis (TEN) is a serious skin condition that can be life-threatening. Often associated with medication use, TEN affects approximately 1-2 people per million, predominantly adults aged 60-80 years.
Common drugs linked to the development of TEN include antiepileptic drugs, sulfonamide antibiotics, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), and others. Among antiepileptic drugs, Lamotrigine (Lamictal), Carbamazepine (Tegretol), Phenytoin (Dilantin), and Oxcarbazepine (Trileptal) are known to pose a high risk. Sulfonamide antibiotics are among the most common antibiotics associated with TEN and Stevens-Johnson Syndrome (SJS). NSAIDs, such as ibuprofen, have also been identified as potential triggers.
TEN is characterized by extensive exfoliation, or skin shedding, resulting in a rash that looks like a severe burn. The top layer of the skin separates from the middle layer, potentially exposing the dermis, which can lead to severe infections, sepsis, and, in some cases, death.
Diagnosing TEN involves examining the skin and taking a small sample (biopsy), and analyzing the sample to determine the cause of the rash. No specific blood tests help diagnose TEN, but doctors may test a person's blood cell count, liver function, blood clotting factors, kidney function, electrolytes and urea levels to monitor the patient's overall health.
In 75% of cases, TEN occurs when the immune system reacts to certain drugs. Treatment for drug-induced TEN involves discontinuing the offending drug and referring the patient to a burn unit or intensive care unit for skin repair.
People who develop TEN may experience a variety of health issues, including scarring of the skin, dental issues, eye conditions, gynecological conditions, urinary problems, breathing problems, and psychological problems like post-traumatic stress disorder. After the skin heals, it's crucial to protect it from the sun to prevent damage and discoloration, and to avoid the offending drug and other drugs in the same medication class.
Eye and vision complications are common after TEN, so doctors may recommend a consultation with an eye doctor, eye drops, or steroids. Recovery from TEN is possible, but it is a serious illness with a mortality rate. The chances of recovery depend on the extent of the skin blistering.
Research suggests that females develop TEN more often than males. Additionally, some studies report that Asian and Black people are more susceptible to TEN than white people. A person may need care from several different specialists, depending on how TEN has affected them.
Treating TEN also requires supportive care, including IV fluids, pain management, wound care, nutritional support, and monitoring for infection. Main causes of death in people with TEN include pulmonary embolism, kidney and heart failure, bleeding in the stomach and intestine, and adult respiratory distress syndrome.
Experts recommend that every person who survives TEN receive mental health support. It's important to remember that early detection and treatment are crucial to prevent fatal outcomes. For those who have recovered, it's essential to follow the recommended care to ensure the best possible outcome.
- The rash associated with Toxic Epidermal Necrolysis (TEN) can resemble severe burns on the skin, a telltale sign of this life-threatening skin condition.
- Similar to TEN, Stevens-Johnson Syndrome (SJS) is also linked to sulfonamide antibiotics, which are among the drugs known to trigger severe skin-and-health issues.
- Beyond skin-care and sun protection, individuals who have recovered from TEN may face various other health-and-wellness challenges, such as scarring, dental issues, and eye conditions.
- In cases where TEN is caused by medications, medical-conditions like post-traumatic stress disorder might develop along with the skin condition.
- Despite TEN being a serious illness with a high mortality rate, the chances of recovery depend on the extent of the skin blistering, and early detection and treatment are crucial for preventing fatal outcomes.
