Toxic epidermal necrolysis caused by carbamazepine

Toxic epidermal necrolysis is a potentially fatal disease, which presents with extensive lesions of the skin, the mucous membrane – especially in the mouth, eyes and genital tract, and sometimes the lining of the intestines and respiratory epithelium. In the clinical picture the changes most often progress rapidly, and erosions of large surfaces occur with the danger of dehydration and super infection. The eyes are very often affected and demand intensive treatment to avoid life-long damage. The involvement of the respiratory epithelium may require intubation, whilst the involvement of the lining of the intestines may lead to ileus or perforation. Therapy procedures for toxic epidermal necrolysis include the immediate suspension of the use of suspect agents, supportive measures and specific therapy, which is always the subject of discussion. Treatment of toxic epidermal necrolysis is complex and demands an inter-disciplinary approach. Treatment includes symptomatic, local and specific therapy.