Cutaneous approach in toxic epidermal necrolysis

ABSTRACT

Introduction:

Toxic epidermal necrolysis is a severe acute mucocutaneous condition usually induced by drugs associated with a high rate of morbidity and mortality. The care of the mucous lesions and skin and a multidisciplinary approach are very important for the prognosis and future sequelae.

Objectives:

To discuss the main aspects of this syndrome through a literature review illustrated by a clinical case. Methods: Review of the literature using the PubMed and SciELO online databases was performed. Articles in English, Portuguese, French, and Spanish were included and illustrated with a pediatric clinical case. The keywords used were as follows: “toxic epidermal necrolysis,” “Stevens- Johnson overlap,” “necrólise epidérmica tóxica,” and “síndrome Stevens-Johnson.”

Results:

We presented data to guide the management of patients with toxic epidermal necrolysis for plastic surgeons, pediatricians, intensivists, dermatologists, and emergency physicians. The case treated had a favorable disease course without sequelae.

Conclusion:

A high level of suspicion is necessary for an adequate diagnosis and risk stratification, and early support measures and treatment should be performed by a multidisciplinary team trained to minimize damage and mortality.

Keywords:
Dermatology; Exanthema; Stevens-Johnson Syndrome; Surgical Procedures; Child.