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

Publication date: August 2018

Source: Journal of Oral and Maxillofacial Surgery, Volume 76, Issue 8

Author(s): Brian Wolf, Rory Sadoff, Victor Nannini

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.

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