For a long time, experience of the treatment of toxic epidermal necrolysis (TEN) was limited to occasional patients. The advent of specialized care units has led to larger series and consequent improvements in therapy. Since the principal causes of death in TEN are sepsis and hypovolemia,1,2 control of infection and fluid balance are of vital importance.3
The management of TEN and second-degree burns have often been compared,4-9 and although many of the principles are the same, there are three important differences. First, in TEN, mucous membrane involvement usually antedates skin necrolysis, hindering eating and drinking for several days before admission and worsening the fluid deficit. Second, systemic involvement renders the patient with TEN sicker than a patient with equally extensive burns. Third, the dissemination of cutaneous lesions often leaves no healthy area for venous access, enhancing the risk of sepsis.
Approximate fluid loss is estimated
Revuz J, Roujeau J, Guillaume J, Penso D, Touraine R. Treatment of Toxic Epidermal NecrolysisCréteil's Experience. Arch Dermatol. 1987;123(9):1156-1158. doi:10.1001/archderm.1987.01660330067010