Toxic Epidermal Necrolysis Successfully Treated With Infliximab

Abstract

Toxic epidermal necrolysis (TEN) is a life-threatening drug-induced cutaneous reaction characterized by widespread apoptosis and detachment of the epidermis. The main causes of death are secondary infections resulting from epidermal damage and multiorgan failure [1]. The severity of illness score (SCORTEN) [2] analyzes 7 independent risk factors and predicts mortality. Older age, significant comorbidity, and greater skin involvement correlate with a worse prognosis [2]. The pathogenesis of TEN is unknown. Several studies suggest that tumor necrosis factor (TNF) α released from inflammatory cells and activated keratinocytes in the epidermis plays an important role in the immune response by inducing direct cytotoxicity and apoptosis [3].