[Toxic Epidermal Necrolysis: Study of an 81-case Series].

Abstract

Toxic epidermal necrolysis (TEN) is a life-threatening, rare and severe mucocutaneous disease. Almost all cases are drug-induced. This study aimed to describe the epidemiological, etiological, clinical, therapeutic and evolutionary data of TEN and to determine the predictive factors of mortality. A retrospective and descriptive study was conducted within the intensive burn care department over a period of 15 years, including all hospitalized cases of TEN. During the study period, 81 were included. The sex ratio (M/F) was 0,68. The mean age was 41±15 years. None of the patients had history of drug allergy. Almost 95% of patients had a comorbidity. Self-medication was observed in 27% of cases. The most frequently implicated drugs were anticonvulsants (37%), antibiotics (21%) and hypouricemic agents (18,5%). The mean time to onset after drug administration was 8 days. The median detached skin surface (DSS) was 40% [30-50]. Mucous membrane was affected in all cases. The main principles of symptomatic therapy include treatment of associated organ dysfunctions and local mucocutaneous treatment. Mechanical ventilation was required in 50% of cases. Evolution was favorable in 42 patients (52%). The median hospital stay was 9 [5-14] days and the median duration of mechanical ventilation was 3 [1-8] days. The mortality rate was 48%. In multivariate study, predictive mortality factors were age >43 years, DSS >39%, ICU admission time >5,5 days, mechanical ventilation requirement and infection occurrence.