Clinical features and prognosis of toxic epidermal necrolysis requiring intensive care: A retrospective descriptive single-center study

Abstract

Background: Toxic epidermal necrolysis (TEN) is the most severe form of drug eruption, necessitating intensive care management in several cases. Although guidelines have been established for diagnosing and treating skin symptoms, few studies have reported on the intensive care management and prognosis of TEN. This study aimed to investigate intensive care for various types of organ failure associated with TEN and their prognoses. Methods: This retrospective, descriptive, single-center study included patients admitted to our intensive care unit (ICU) for treatment of TEN over a 10-year period. We investigated the participants’ characteristics, organ failure and management, duration of ICU and hospital stay, and prognosis, through the electronic medical and ICU progress records. Results: This study enrolled eight patients. Most patients presented with multiple organ failure, and in-hospital mortality was 50%. The median SOFA score at ICU admission was 9.5, and the median maximum SOFA score during ICU stay was 16.0. All patients underwent mechanical ventilation. Renal replacement therapy was administered to five patients. The median length of stay in the ICU was 31.5 days, and the median duration of hospitalization was 87 days. Survivors required long-term hospitalization, and only one patient was discharged home. Conclusions: Most TEN patients admitted to the ICU had multiple organ failure, and poor short- and long-term prognoses.

Keywords

• Multiple organ failure
• Prognosis
• Toxic epidermal necrolysis
• TEN
• Drug eruption