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Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a type of severe skin reaction. [2] Together with Stevens–Johnson syndrome (SJS) it forms a spectrum of disease, with TEN being more severe. [ 2 ]
Stevens–Johnson syndrome (SJS) is a milder form of toxic epidermal necrolysis (TEN). [50] These conditions were first recognized in 1922. [27] A classification first published in 1993, that has been adopted as a consensus definition, identifies Stevens–Johnson syndrome, toxic epidermal necrolysis, and SJS/TEN overlap.
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The SCORTEN scale (SCORe of Toxic Epidermal Necrosis) is a severity-of-illness scale with which the severity of certain bullous conditions can be systematically determined. It was originally developed for toxic epidermal necrolysis , [ 1 ] but can be used with burn victims, sufferers of Stevens–Johnson syndrome , cutaneous drug reactions, or ...
Stevens–Johnson syndrome, toxic epidermal necrolysis, and Stevens–Johnson syndrome/Toxic epidermal necrolysis overlap syndrome are a spectrum of Type IV, Subtype IVc, delayed hypersensitivity reactions, i.e. reactions initiated by CD8 + T cells and natural killer T cells. [2]
Nikolsky's sign is almost always present in Stevens–Johnson syndrome/toxic epidermal necrolysis [5] and staphylococcal scalded skin syndrome, caused by the exfoliative toxin of Staphylococcus aureus. [1] It is also associated with pemphigus vulgaris and pemphigus foliaceus.
In dermatology, erythema multiforme major is a form of rash with skin loss or epidermal detachment. The term "erythema multiforme majus" is sometimes used to imply a bullous (blistering) presentation. [2] According to some sources, there are two conditions included on a spectrum of this same disease process: Stevens–Johnson syndrome (SJS)
Erythema multiforme, Toxic epidermal necrolysis Apoptotic and necrotic cells, absence of acantholytic cells A Tzanck smear may be a rapid test to distinguish toxic epidermal necrolysis from SSSS III. Genodermatoses: Hailey-Hailey disease: Acantholytic cells without direct immunofluorescence positivity