Toxic epidermal necrolysis (TEN): Acute complications and long-term sequelae management in a multidisciplinary follow-up.

Abstract

Toxic epidermal necrolysis (TEN) is a devastating exfoliative disorder with life-changing complications. This study aimed to identify acute complications and long-term sequelae of TEN and to highlight the importance of a multidisciplinary management follow-up. A 19-year (1998-2016) retrospective review of all patients with TEN admitted to Cruces University Hospital´s Burns Unit was performed. Demographic and admission data were collected. Survivors were contacted for a follow-up multidisciplinary assessment involving dermatological, ocular, ENT, urological, gynecological, and psychological examination. Within the total cohort of patients analyzed (22), 6 survivors agreed to be interviewed. The patients presented with both physical and psychological sequelae, including dermatological (100%), oropharyngeal (50%), and ophthalmologic sequelae (50%), with corneal damage and severe dry eye as the most frequent. The only male patient underwent phimosis surgery due to mucosal adhesions. Psychometric scales captured symptoms of post-traumatic stress disorder (33.33%), and quality of life was affected in 66.67% of the patients by skin sequelae. Quality of life can be severely impaired by multiple long-term complications. It is important to emphasize the need for multidisciplinary awareness during their acute stay at Burns Unit. Furthermore, long-term follow-up might prevent or limit the progression of the chronic sequelae.