1. EMedicine - Toxic Epidermal Necrolysis : Article By Gregory P Garra, DO toxic epidermal necrolysis Described in 1956 by Alan Lyell, toxic epidermalnecrolysis (TEN) is a rapidly evolving mucocutaneous reaction characterized by http://www.emedicine.com/EMERG/topic599.htm

(advertisement) Home Specialties Resource Centers CME ... Patient Education Articles Images CME Advanced Search Consumer Health Link to this site Back to: eMedicine Specialties Emergency Medicine Infectious Diseases Toxic Epidermal Necrolysis Last Updated: June 13, 2005 Rate this Article Email to a Colleague Synonyms and related keywords: TEN, Lyell's disease, mucocutaneous exfoliative disease, erythema multiforme, EM, bullous erythema multiforme, Stevens-Johnson syndrome, SJS, mucocutaneous reaction, widespread erythema, necrosis, bullous detachment of the epidermis, SJS-TEN, TEN with spots, TEN without spots AUTHOR INFORMATION Section 1 of 9 Author Information Introduction Clinical Differentials ... Bibliography Author: Gregory P Garra, DO , Clinical Assistant Professor of Emergency Medicine, Stony Brook University School of Medicine; Program Director, Department of Emergency Medicine, Stony Brook University Hospital Coauthor(s): Peter Viccellio, MD , Vice-Chair, Professor, Department of Emergency Medicine, State University of New York at Stony Brook Gregory P Garra, DO, is a member of the following medical societies:

2. Stevens Johnson Syndrome Foundation Nonprofit organization dedicated to providing information and support to persons afflicted with Stevens Johnson Syndrome and toxic epidermal necrolysis. http://www.stevensjohnsonsyndrome.net

3. Toxic Epidermal Necrolysis toxic epidermal necrolysis This kind of drug eruption is the most severe kind. http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

4. EMedicine - Toxic Epidermal Necrolysis : Article By Victor Cohen, PharmD toxic epidermal necrolysis Alan Lyell provided an early description of toxicepidermal necrolysis (TEN) in 1956. Lyell described TEN as. http://www.emedicine.com/med/topic2291.htm

(advertisement) Home Specialties Resource Centers CME ... Patient Education Articles Images CME Patient Education Advanced Search Consumer Health Link to this site Back to: eMedicine Specialties Medicine, Ob/Gyn, Psychiatry, and Surgery Infectious Diseases Toxic Epidermal Necrolysis Last Updated: June 13, 2005 Rate this Article Email to a Colleague Synonyms and related keywords: acute disseminated epidermal necrosis, acute skin failure, Lyell syndrome, TEN, Stevens-Johnson syndrome, SJS-TEN AUTHOR INFORMATION Section 1 of 11 Author Information Introduction Clinical Differentials ... Bibliography Author: Victor Cohen, PharmD , Clinical Coordinator, Department of Emergency Medicine, Maimonides Medical Center, Assistant Professor, Division of Pharmacy Practice, Schwartz College of Pharmacy and Health Sciences Coauthor(s): Robert A Schwartz, MD, MPH , Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School Victor Cohen, PharmD, is a member of the following medical societies:

5. Toxic Epidermal Necrolysis - Dermatology Health Guide Overview of toxic epidermal necrolysis http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

6. Toxic Epidermal Necrolysis - Dermatology Health Guide Overview of toxic epidermal necrolysis. toxic epidermal necrolysis is alifethreatening skin disorder characterized by a blistering and peeling of the http://www.umm.edu/dermatology-info/toxic.htm

var MenuLinkedBy='AllWebMenus [2]', awmBN='530'; awmAltUrl=''; Dermatology Health Guide Anatomy of the Skin Common Skin Disorders... Describing a Skin Condition ... Glossary Related Resources Within UMM Dept. of Dermatology Translate using Google to Spanish German French Italian Portuguese Dermatology Toxic Epidermal Necrolysis What is toxic epidermal necrolysis? Toxic epidermal necrolysis is a life-threatening skin disorder characterized by a blistering and peeling of the top layer of skin. This disorder can be caused by a drug reaction most often penicillin or another disease. About one-third of all diagnosed cases of toxic epidermal necrolysis are a result of unknown causes. What are the symptoms of toxic epidermal necrolysis? Toxic epidermal necrolysis can cause the skin to peel off in sheets, leaving large areas that look scalded. The loss of skin causes fluids and salts to ooze from the raw, damaged areas which can easily become infected. The following are the most common symptoms of toxic epidermal necrolysis. However, each person may experience symptoms differently: a painful, red area that spreads quickly

7. Grand Rounds Archives ERYTHEMA MULTIFORME AND toxic epidermal necrolysis Michael G. Stewart, MD February 20, 1992 Clinical Features http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

8. Toxic Epidermal Necrolysis. DermNet NZ Authoritative facts about the skin from the New Zealand Dermatological Society. http://dermnetnz.org/reactions/toxic-epidermal-necrolysis.html

@import url("/common/screen.css"); DermNet NZ Ad Authoritative facts about the skin from the New Zealand Dermatological Society Incorporated Home For patients For doctors ... Site map Search: Home Reactions Toxic epidermal necrolysis What is toxic epidermal necrolysis? Toxic epidermal necrolysis (TEN) is luckily very rare as it is often fatal. It is characterised by blistering and peeling of the top layer of skin. The lesion resembles that of a severe burn and needs to be distinguished from staphylococcal scalded skin syndrome , which has a similar appearance but the blister arises nearer to the skin surface. A skin biopsy is often necessary to distinguish these two diseases. It is thought to be related to a severe form of erythema multiforme , Stevens-Johnson syndrome. What causes toxic epidermal necrolysis? TEN is most often caused by an adverse reaction to a drug, but it sometimes arises in patients who are not taking any medications. Non-drug causes include bacterial or viral infection, malignant tumours, vaccinations or no apparent cause (idiopathic). Drugs that are known to cause TEN include: Antibiotics Sulphonamides Penicillins Macrolides Quinolones Allopurinol Nonsteroidal anti-inflammatory drugs (NSAIDs) Anticonvulsants (antiepileptic medicines) Who is at risk of toxic epidermal necrolysis?

9. Treatment Of Severe Drug Reactions Stevens-Johnson Syndrome Treatment of severe drug reactions StevensJohnson Syndrome, toxic epidermal necrolysis and Hypersensitivity syndrome Pierre-Dominique Ghislain M.D. http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

10. Toxic Epidermal Necrolysis CHC Wausau Hospital s Medical Library and Patient Education Center providesresearch services and healthcare information to physicians, http://www.chclibrary.org/micromed/00068540.html

Main Search Index Definition Description Causes ... Resources Toxic epidermal necrolysis Definition Toxic epidermal necrolysis is a rare condition that causes large portions of the epidermis, the skin's outermost layer, to detach from the layers of skin below. A reaction to a medication is the primary cause. Description Toxic epidermal necrolysis (TEN) begins with fever cough , and other nonspecific symptoms, and is soon followed by purplish, bloody-looking lesions on the skin and mucous membranes. These early lesions, typically found on the head, neck, and upper chest, soon merge and blister. Sheets of epidermis then begin to detach from the skin layers below. In time, the entire surface of the skin may be involved, with detachment of 100% of the epidermis. The main cause of TEN is a severe drug reaction. Some investigators believe there may be additional infectious causes. A severe reaction in transplant patients, called graft-vs.-host disease, can also produce TEN. One study reported more than 100 different drugs as causes of TEN. The drugs most commonly implicated, however, include antibacterial sulfonamides such as sulfadiazine

11. Discover Fire In The Flesh - Toxic Epidermal Necrolysis Full text of the article, 'Fire in the Flesh toxic epidermal necrolysis' from Discover, a publication in the field of Reference Education, is http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

12. Toxic Epidermal Necrolysis toxic epidermal necrolysis toxic epidermal necrolysis (TEN) begins with fever,cough, and other nonspecific symptoms, and is soon followed by purplish, http://www.healthatoz.com/healthatoz/Atoz/ency/toxic_epidermal_necrolysis.jsp

13. USATODAY.com - Patients Encouraged To Ask Doctors About Alternatives A The skin reactions include conditions called StevensJohnson Syndrome and toxic epidermal necrolysis. http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

14. THE MERCK MANUAL--SECOND HOME EDITION, Stevens-Johnson Syndrome And Toxic Epider StevensJohnson syndrome and toxic epidermal necrolysis are two forms of the same In toxic epidermal necrolysis, there is a similar blistering of mucous http://www.merck.com/mmhe/sec18/ch203/ch203e.html

var externalLinkWarning = "The link you have selected will take you to a site outside Merck and The Merck Manuals.*n*nThe Merck Manuals do not review or control the content of any non-Merck site. The Merck Manuals do not endorse and are not responsible for the accuracy, content, practices, or standards of any non-Merck sources."; Search The Second Home Edition , Online Version Search Index A B C D ... Z Sections Accidents and Injuries Blood Disorders Bone, Joint, and Muscle Disorders Brain, Spinal Cord, and Nerve Disorders ... Women's Health Issues Resources Anatomical Drawings Multimedia Pronunciations Weights and Measures ... , Online Version Section Skin Disorders Chapter Itching and Noninfectious Rashes Topics Introduction Dermatitis Drug Rashes Erythema Multiforme ... Rosacea Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Buy The Book Print This Topic Email This Topic Pronunciations allopurinol barbiturates carbamazepine corticosteroid ... urethra Stevens-Johnson syndrome and toxic epidermal necrolysis are two forms of the same life-threatening skin disease that cause rash, skin peeling, and sores on the mucous membranes. In Stevens-Johnson syndrome, a person has blistering of mucous membranes, typically in the mouth, eyes, and vagina, and patchy areas of rash. In toxic epidermal necrolysis, there is a similar blistering of mucous membranes, but in addition the entire top layer of the skin (the epidermis) peels off in sheets from large areas of the body. Both disorders can be life threatening.

15. EMedicine - Toxic Epidermal Necrolysis Article By Victor Cohen toxic epidermal necrolysis Alan Lyell provided an early description of toxic epidermal necrolysis (TEN) in 1956. Lyell described TEN as http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

16. THE MERCK MANUAL, Sec. 10, Ch. 118, Inflammatory Reactions toxic epidermal necrolysis. A lifethreatening skin disease in which the epidermispeels toxic epidermal necrolysis (TEN) most often occurs in adults. http://www.merck.com/mrkshared/mmanual/section10/chapter118/118c.jsp

17. Forbes.com Lawsuit Charges Motrin Can Harm Children medication, specifically the risk of developing two disorders Stevens-Johnson Syndrome and toxic epidermal necrolysis - which are typically http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

18. Postgraduate Medicine: Pearls In Dermatology A diagnosis of toxic epidermal necrolysis induced by TMPSMZ was made. toxic epidermal necrolysis (TEN) is a clinical syndrome characterized by severe http://www.postgradmed.com/issues/2000/04_00/brodell.htm

PEARLS IN DERMATOLOGY Toxic epidermal necrolysis A widespread, life-threatening blistering reaction Paul Watanakunakorn, MD; Robert T. Brodell, MD VOL 107 / NO 4 / APRIL 2000 / POSTGRADUATE MEDICINE A n 18-year-old woman had a 3-day history of skin tenderness over her entire body and blistering involving 40% of her body surface area, including face, trunk, upper arms, and thighs. Mucosal tissues, including lips, throat, conjunctivae, and labia, were tender and eroded (figure 1). One week before onset of symptoms, she had been treated with trimethoprim-sulfamethoxazole (TMP-SMZ) for a urinary tract infection. A diagnosis of toxic epidermal necrolysis induced by TMP-SMZ was made. The patient was admitted to a burn unit and carefully handled to prevent further tissue sloughing. Treatment consisted of administration of fluids to achieve balance, nutritional support, oral prednisone (60 mg per day for 4 days), and local application of mupirocin ointment. The patient's condition stabilized over 2 weeks, and she was discharged. Figure 1. Denuded skin with flaccid blisters over the cheeks, neck, and chest of 18-year-old patient with toxic epidermal necrolysis. Lips are eroded and erythematous. Dermal-epidermal separation (below the pigmented layer of epidermis) is evidenced by lighter shade of exposed dermis on chest in contrast to darker tan of surrounding skin.

19. Stevens Johnson Syndrome Foundation Stevens Johnson Syndrome/toxic epidermal necrolysis Adverse drug reactions. Painful Blistering of the skin and mucous membrane involvment. http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

20. Stevens Johnson Syndrome - Skinassn.org Another form of the disease is called toxic epidermal necrolysis, and again this toxic epidermal necrolysis provides information on Toxic Epidermal http://www.skinassn.org/

Stevens Johnson Syndrome What is Stevens Johnson Syndrome? Causes Of Stevens Johnson Syndrome Toxic Epidermal Necrolysis ... Contact An Attorney Specializing In Stevens Johnson Syndrome Stevens-Johnson Syndrome Stevens-Johnson Syndrome is a potentially deadly skin disease that usually results from a drug reaction. Another form of the disease is called Toxic Epidermal Necrolysis, and again this usually results from a drug-related reaction. Drugs that have been linked to Stevens-Johnson Syndrome include NSAIDS (non-steroid anti-inflammatory drugs), Allopurinol, Phenytoin, Carbamazepine, barbiturates, anticonvulsants, and sulfa antibiotics. In some cases, the condition is caused by a bacterial infection, and in many cases there is no known cause for the onset of Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis. These skin diseases can cause massive pain, suffering and anxiety. People that have taken or are taking medications such as the ones mentioned above are urged to familiarise themselves with the symptoms of SJS (Stevens-Johnson Syndrome) and Toxic Epidermal Necrolysis (TEN). This will enable you to seek immediate medical attention should the need arise, and early initiation of treatment can make a big difference to the seriousness of the disease as this can stop any secondary infections. The aim of this site is to keep people informed about the symptoms, causes and treatment of SJS and TEN, and also to offer advice with regards to the legal options of those affected by these diseases. You can find out more about various aspects of these diseases through the following articles:

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