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Toxic Epidermal Necrolysis

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The American Heart Association presented with a report indicating patients using Bextra while recovering from heart surgery were 2.19 times more likely to suffer a stroke or heart attack than those taking placebos.

Toxic Epidermal Necrolysis (TEN) and Stevens Johnson Syndrome (SJS) are two forms of the skin disease that can cause rash, skin peeling, and sores on the mucous membranes. Stevens Johnson Syndrome is an immune-complex-mediated hypersensitivity disorder that may be caused by many drugs, viral infections, and malignancies. Often, the drugs causing the onset of Stevens Johnson Syndrome, such as BEXTRA ®, did not have warnings placed on their labels until recently. Patients unknowingly took these drugs and many developed the potentially fatal Stevens Johnson Syndrome.

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 top layer of skin. This disorder can be caused by a drug reaction -- most often penicillin -- or another disease. About one-third of all diagnosed cases of toxic epidermal necrolysis are a result of unknown causes.

What are the symptoms of toxic epidermal necrolysis?
Toxic epidermal necrolysis can cause the skin to peel off in sheets, leaving large areas that look scalded. The loss of skin causes fluids and salts to ooze from the raw, damaged areas which can easily become infected. The following are the most common symptoms of toxic epidermal necrolysis. However, each person may experience symptoms differently:

  • A painful, red area that spreads quickly
  • The top layer of skin may peel without blistering
  • Scalded-looking raw areas of flesh
  • Discomfort
  • Fever
  • Condition spread to eyes, mouth, and genitals

The symptoms of toxic epidermal necrolysis may resemble other dermatologic conditions. Consult a physician for diagnosis.

Treatment for toxic epidermal necrolysis:

The progression of the disease happens fast, usually within three days. Treatment usually includes hospitalization, often in the burn unit. If a medication is causing the skin reaction, the patient is immediately taken off the medication. Your physician based on will determine specific treatment for toxic epidermal necrolysis:

  • Your overall health, age, and medical history
  • Severity of the condition
  • Your tolerance of specific medications, procedures, or therapies
  • Your opinion or preference

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

  • Isolation to prevent infection
  • Protective bandages
  • Intravenous fluid and electrolytes
  • Antibiotics

Source: University of Maryland Medicine


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