The lesions of toxic epidermal necrolysis (TEN) generally begin on the face and upper body and rapidly extend to the entire skin surface but predominate on the trunk and the proximal aspect of the limbs.1 The cause of the distribution of lesions, and of the process itself, remains obscure. We observed a case of TEN that distinctly spared a skin graft whose donor site was uninvolved as well. This observation suggests that TEN expression is donor-site dominant.
Report of a Case.
A 40-year-old man was admitted to the hospital with a 3-day history of progressive erythema beginning on his face and spreading caudally. Blister formation and denudation of skin commenced across the neck on the day of admission.His history was remarkable for a melanoma (Clark level 3) on his upper back 5 years earlier. Treatment then included surgical excision and placement of a splitthickness skin graft taken from
Pion IA, Bystryn J. Expression of Toxic Epidermal Necrolysis in Grafted Skin Is Donor-Site Dominant. Arch Dermatol. 1993;129(8):1057-1058. doi:10.1001/archderm.1993.01680290133025