Toxic epidermal necrolysis: The Daily PANCE Blueprint
Which of the following drug classes is most commonly associated with toxic epidermal necrolysis (TEN)?
A. Anticonvulsants
B. NSAIDs
C. Antifungals
D. Antibiotics
E. Beta blockers
Answer and topic summary
The answer is D. Antibiotics
Toxic epidermal necrolysis (TEN) is a rare, immune-mediated dermatologic disorder. It typically presents as widespread, painful erythematous or dusky-red macules that progress into blisters, epidermal detachment, and denuded areas resembling severe burns. Early lesions usually start on the face, trunk, and proximal extremities. Niklosky’s sign is positive (epidermis sloughs off with gentle lateral pressure). Mucosal involvement is common and may precede skin findings. It is the same as Stevens-Johnson syndrome (SJS); the only difference is the extent of skin involvement. SJS impacts <10% of the surface area of the skin, TEN impacts >30%. Etiologies include medications (e.g., antibiotics most commonly, AEDs, NSAIDs, allopurinol) and infections. Treatment is similar to how you would manage burns; there is no definitive therapy.
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Dermatology ⇒ ⇒
