Toxic epidermal necrolysis (TEN) is a rare and serious skin condition. Often, it’s caused by an adverse reaction to medication likeanticonvulsantsor antibiotics.

The main symptom is severe skin peeling and blistering. The peeling progresses quickly, resulting in large raw areas that may ooze or weep. It also affects the mucous membranes, including the mouth, throat, eyes, and genital region.

医疗紧急情况

Since TEN develops rapidly, it’s important to get help as soon as possible. TEN is a life threatening emergency that requires immediate medical treatment.

继续阅读，探讨十的原因和症状，以及如何治疗。

因为十个是如此罕见，它没有完全理解。它通常由对药物的异常反应引起的。有时候，难以确定十的潜在原因。

药物

The most common cause of TEN is an abnormal reaction to medication. It’s also known as a dangerous type of药疹, and is responsible for up to95 percentof TEN cases.

通常，该病症在服用药物的前8周内形成。

以下药物最常见于十个：

  • anticonvulsants
  • Oxicams（非甾体抗炎药）
  • 磺酰胺抗生素
  • Allopurinol（用于痛风和预防肾结石）
  • 奈韦拉平(anti-HIV drug)

感染

在非常罕见的情况下，十种疾病与被称为的细菌的感染有关Mycoplasma pneumoniae, which causes a respiratory infection.

The symptoms of TEN are different for each person. In the early stages, it usually causes流感样症状。This may include:

  • 发热
  • 身体疼痛
  • red, stinging eyes
  • 吞咽困难
  • runny nose
  • coughing
  • 咽喉痛

After 1 to 3 days, the skin peels with or withoutblistering。这些症状可以在几个小时或几天内进行。

其他症状包括：

  • red, pink, or purple patches
  • painful skin
  • 大，原料的皮肤区域（侵蚀）
  • symptoms spreading to the eyes, mouth, and genitals

十的主要症状是皮肤的痛苦剥离。随着条件的进展，剥离在整个身体中迅速蔓延。

以下是十个的视觉例子。

史蒂文斯 - 约翰逊综合征（SJ），如十，是药物引起的严重皮肤病，或者很少与感染相关。这两个条件是相同的疾病和涉及的皮肤量不同。

SJS is less severe. For example, in SJS, less than10 percent身体受皮肤剥皮的影响。十分之一，超过30％is affected.

However, SJS is still a serious condition. It also requires immediate emergency medical attention.

SJS and TEN often overlap, so the conditions are sometimes referred to as Stevens-Johnson syndrome/toxic epidermal necrolysis, or SJS/TEN.

Though anyone taking medication can develop TEN, some people have a higher risk.

可能的风险因素包括：

  • Older age.十个可以影响所有年龄段的人，但它更有可能影响老年人。
  • 性别。Females may have a higher risk of TEN.
  • Weakened immune system.免疫系统较弱的人更喜欢ly to develop TEN. This may occur due to conditions like cancer orHIV。
  • AIDS.SJS and TEN are1000倍更常见in people with AIDS.
  • Genetics.如果您有HLA-B * 1502等位基因，风险更高，这在东南亚，中国人和印度血统的人们中最常见。当你服用某种药物时，基因可以增加你十个的风险。
  • Family history.如果立即相对的情况，你可能更有可能发展十。
  • Past drug reactions.如果您在服用某种药物后开发了十个，如果您服用相同的药物，您可能会增加风险。

A doctor will use a variety of tests to diagnose your symptoms. This may include:

  • 体检。During aphysical exam, a doctor will inspect your skin for peeling, tenderness, mucosal involvement, and infection.
  • Medical history.To understand your overall health, a doctor will ask about your medical history. They’ll also want to know what drugs you take, including any new medications taken in the past two months, as well as any allergies you have.
  • 皮肤活组织检查。During a皮肤活组织检查, a sample piece of affected skin tissue is removed from your body and sent to a lab. A specialist will use a microscope to examine the tissue and look for signs of TEN.
  • 验血。A验血can help identify signs of infection or other problems with internal organs.
  • Cultures.医生也可以通过订购血液或血液来寻找感染皮肤文化。

While the doctor is usually able to diagnose TEN with a physical exam alone, a skin biopsy is often performed to confirm the diagnosis.

In all cases, treatment includes discontinuing the drug that caused your reaction.

其他形式的治疗取决于几个因素，例如：

  • 你的年龄
  • 你的整体健康and medical history
  • the severity of your condition
  • the affected body areas
  • your tolerance of certain procedures

Treatment will involve:

  • 住院。Everyone with TEN needs to be cared for in a burn unit.
  • 软膏和绷带。适当的伤口护理将防止进一步的皮肤损伤并保护原始皮肤免受流体损失和感染。为了保护您的皮肤，您的医院团队将使用局部药膏和伤口敷料。
  • Intravenous (IV) fluid and electrolytes.Extensive burn-like skin loss, especially in TEN, leads to fluid loss and electrolyte imbalance. You’ll be givenIV fluid和电解质以最大限度地减少风险。您的医院团队将密切监控电解质，内脏的状态，以及您的整体流体状态。
  • 隔离。Since the skin damage of TEN increases the risk of infection, you will be isolated from others and potential sources of infection.

药物s used to treat TEN include:

  • 抗生素。Almost everyone with TEN is given抗生素预防或治疗任何感染。
  • 静脉内免疫球蛋白G（IVIG）。免疫球蛋白是帮助免疫系统的抗体。Ivig有时用于控制反应。这是一off-label useof IVIG.
  • TNF alpha inhibitor etanercept and immunosuppressant cyclosporine.These are promising treatments that are often recommended by experts in the treatment of TEN. This is anoff-label useof both medications.

Specific body parts may need different treatments. For example, if your mouth is affected, a specific prescription mouthwash may be used in addition to other treatments.

Your hospital team will also closely monitor your eyes and genitals for signs. If they detect any signs, they’ll use specific topical treatments to prevent complications, such as vision loss and scarring.

Currently, there is no standard treatment regimen for TEN. Treatment may vary depending on the hospital. For example, some hospitals may use IVIG, while others may use a combination of etanercept and cyclosporine.

依那西普和环孢菌素目前不被食品和药物管理局（FDA）批准治疗十个。但是，它们可以为此目的而被使用。偏离标签用途意味着您的医生可以为某种药物规定，如果您认为您可能会受益于药物，那么它就无法批准。Learn more about off-label prescription drug use.

The mortality rate of TEN is approximately30％，但可以更高。但是，许多因素会影响您的个人前景，包括您的：

  • 年龄
  • overall health
  • severity of your condition, including body surface area involved
  • 治疗过程

In general, recovery can take 3 to 6 weeks. Possible long-term effects include:

  • 皮肤变色
  • 疤痕
  • dry skin and mucous membranes
  • hair loss
  • trouble urinating
  • impaired taste
  • genital abnormalities
  • 视力变化，包括损失

Toxic epidermal necrolysis (TEN) is a serious emergency. As a life threatening skin condition, it can quickly lead to dehydration and infection. Get medical attention immediately if you or someone you know has symptoms of TEN.

Treatment includes hospitalization and admission to a burn unit. Your hospital team will prioritize wound care, fluid therapy, and pain management. It can take up to 6 weeks to get better, but early treatment will improve your recovery and outlook.