toxic epidermal necrolysis

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Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are two versions of the same disease, distinguished from each other by severity. Both are hypersensitive life-threatening skin reactions, usually to a drug, that causes the skin to:

  • Form a severe rash
  • Blister
  • Peel
  • Shed

People who experience Stevens-Johnson syndrome or toxic epidermal necrolysis will also develop painful sores in the mucous membranes of the:

  • Mouth
  • Ears
  • Eyes
  • Nose
  • Genital area

During the beginning stages, a patient will usually feel very sick and the affected areas of the skin are painful. Before the outbreak on the skin, a patient may experience fever, cough, sore throat body aches, chills and other flu-like symptoms.

When Stevens-Johnson Syndrome Becomes Toxic Epidermal Necrolysis

The two disorders are different versions of the same disease at opposite ends of a spectrum of severity. When 10 percent or less of the body area is affected, the disorder is called Stevens-Johnson syndrome. When 30 percent or more of the skin is affected, it is considered toxic epidermal necrolysis (TEN). If between 10 and 30 percent of the skin is involved, it is considered to be an overlapping SJN-TEN syndrome.

The skin in both levels of the disease will blister, peel and fall off. People with toxic epidermal necrolysis will experience the symptoms over larger areas of the body, and the skin may begin to peel off in sheets (otherwise known as sloughing). The death rate is about 7.5 percent in children and 20 to 25 percent in adults. The prognosis depends upon how early the Toxic Epidermal Necrolysis diagnosis is made and treatment begins.

Because a patient's body reacts similarly to the body of a burn victim, treatments will likely be done in a hospital burn unit, where the patient receives fluids and salts intravenously and the skin is scrupulously cared for to prevent infection.

Causes of Toxic Epidermal Necrolysis

According to reports, Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are almost always caused by a severe allergic reaction to a drug, usually a sulfa antibiotic. Drugs cause more than 50 percent of the Stevens-Johnson syndrome cases, and as much as 95 percent of toxic epidermal necrolysis cases. Aside from sulfa drugs, other drugs known to cause Stevens-Johnson Syndrome are:

  • Other antibiotics
  • Some over-the-counter nonsteroidal anti-inflammatory drugs
  • Anticonvulsant medications
  • Barbiturates
  • A drug to treat gout

AIDS patients are said to be at a higher risk of developing the skin disease as well as others with compromised immune systems. In addition to drugs, infections can lead to the disorders, including:

  • Herpes (herpes simplex or herpes zoster)
  • Influenza
  • HIV
  • Diphtheria
  • Typhoid
  • Hepatitis

Some vaccinations, graft-vs.-host diseases, and radiation therapy or ultraviolet light have also been reported to cause the disorders.

For more information, or if you would like to speak with a qualified legal professional about a case of Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN), contact our Toxic Epidermal Necrolysis lawyers today.