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#1
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06-07-2009, 04:18 PM
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Toxic Epidermal Necrosis
Toxic Epidermal Necrosis is a severe reaction to certain medications (usually antibiotics, anti-inflammatories, anti-convulsants, and corticosteroids). There is a 30-40% mortality rate. "The initial symptoms of TEN are similar to an upper respiratory infection: malaise, rash, fever, cough, arthralgia, myalgia, rhinitis, headache, anorexia, and nausea and vomiting, with or without diarrhea. When the rash forms, it covers large segments of the body. Within hours, the skin takes on the appearance of a severe burn, with blisters forming and the epidermis beginning to peel away from the underlying tissues. Mucous membranes, such as the mouth, throat, digestive tract, along with genitals and eyes may be severely effected. The mouth becomes blistered and eroded, making eating difficult and sometimes necessitating feeding through a nasogastric tube through the nose or a gastric tube directly into the stomach. The eyes become swollen, crusted, and ulcerated." "Treatment for TEN consists of keeping the patient warm and applying constant hydration via IV, eye irrigation and hydrotherapy. Necrotic areas of the skin are debrided and physical therapy is provided to keep the range of motion intact. A variety of ointments are applied to the skin during the course of the disease, and, of course, lots of opiates are given to the patients to help them weather the excrutiating pain. " |
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#4
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06-08-2009, 05:56 AM
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Re: Toxic Epidermal Necrosis
looks horrifying, even the treatments of this aren't that great. First line is Immuniglobin E, followed by Immunosuppresants (YES the opposite of the that^) keep in mind ALL Steroids are immunosuppresants(Dexamethasone <12mg, predisolone LOW dose, Hydrocortisone), and tertiary care involves administering medication which reduces the acidity, NAC (N-acetyl-cysteine 150mg) NAC is used for its nephroprotective and heaptoprotective effects. Indeed this is a nasty disease indeed, more over, its LIFE THREATening.
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#9
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06-14-2009, 10:05 AM
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Re: Toxic Epidermal Necrosis
From what I understand, it can happen to anyone... you take some medication that your body doesn't like or can't deal with, and so it deposits it in the skin. And then your helpful immune system comes around and starts killing your skin in the process of trying to get rid of the substance.
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