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Management of Toxic Epidermal Necrolysis: Indian Guidelines

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Dr Lalit Kumar Gupta, Udaipur    22 January 2019

  • Toxic epidermal necrolysis (TEN) is a life-threatening mucocutaneous systemic illness, mostly drug-induced that requires early recognition and prompt management.
  • There is no consensus and uniformity in the use of specific agents due to rarity of disease and lack of randomized control trials.
  • Corticosteroids in sufficiently high doses for a short period (7-10 days) have been traditionally used for years with success.
  • Cyclosporine is currently proving to be of great value and may replace corticosteroids in future.
  • Intravenous immunoglobulin (IVIG) once very commonly used has fallen in disrepute due to its high cost and toxicity.
  • Tumor necrosis factor (TNF)-a inhibitors are also being re-tried with some success.
  • Indian guidelines (2016) prepared by IADVL special interest group (published in IJDVL, Dec 2016 issue) serve as an important guide to the clinicians in effectively managing their patients with TEN in an evidence-based manner and will be discussed.

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