Canis ISSN: 2398-2942

Skin: toxic epidermal necrolysis

Synonym(s): TEN

Contributor(s): Kyle Braund, Richard Squires

Introduction

  • Rare, severe, life-threatening, ulcerative immune-mediated disease Toxic epidermal necrolysis.
  • A true dermatological emergency.
  • Cause: usually drug induced or secondary to infectious disease or toxins.
  • Signs: similarities to thermal burns.
  • Diagnosis: history, clinical signs, histopathology.
  • Treatment: fluid therapy, chemotherapy.
  • Prognosis: mortality up to 50%.

Pathogenesis

Etiology

Pathophysiology

  • Unclear; may be due to defective epidermal detoxification of drug byproducts.
  • Probably an epitheliotropic lymphocyte-macrophage-mediated immunological process.
  • Clefting at dermo-epidermal junction → bullae formation, vesicles → widespread ulceration.

Timecourse

  • If underlying cause can be corrected and intensive supportive care is provided, should improve over 2-3 weeks.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Lewis D T (1998) Life-threatening dermatoses in dogs. Comp Cont Ed Pract Vet 20 (3), 271-283 VetMedResource.
  • Rachofsky M A, Chester D K & Read W K (1989) Toxic epidermal necrolysis. Comp Cont Educ Pract Vet 11 (7), 840-845 VetMedResource.


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