Toxic Epidermal Necrolysis: A Dermatologic Emergency and the Role of the Oral and Maxillofacial Surgeon

J Oral Maxillofac Surg. 2018 Aug;76(8):1688-1694. doi: 10.1016/j.joms.2018.02.016. Epub 2018 Feb 23.

Abstract

Toxic epidermal necrolysis (TEN) is a rare and severe mucocutaneous disorder characterized by mucosal and epidermal necrosis and sloughing. This potentially life-threatening condition, together with the less severe Stevens-Johnson syndrome, is commonly caused by an immunologic reaction to medications and can lead to many long-term complications. The disorder initially presents with fever, malaise, and painful mucosal ulcerations (most commonly oral) but progresses to widespread cutaneous lesions. A 14-year-old male patient was prescribed minocycline for treatment of his acne by his primary care doctor. Three weeks into the antibiotic treatment, he was admitted in distress, with a diagnosis of Stevens-Johnson syndrome that subsequently progressed to TEN. We present a discussion of the importance of early recognition and diagnosis of this condition by oral and maxillofacial surgeons and a description of our patient's treatment and management during his hospital stay.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Combined Modality Therapy
  • Emergencies
  • Humans
  • Male
  • Oral and Maxillofacial Surgeons*
  • Physician's Role*
  • Stevens-Johnson Syndrome / diagnosis*
  • Stevens-Johnson Syndrome / therapy*