Diagnosis
TEN is diagnosed when people with SJS develop severe disease that affects more than 30% of the body.
Treatment
If your doctor suspects that your TEN was caused medicine you took, you'll need to stop taking that drug. Then you'll likely be moved to a hospital for treatment, possibly in its burn center or intensive care unit. Full recovery can take several months.
Supportive care
The main treatment for TEN is trying to make you as comfortable as possible while your skin heals. You'll receive this supportive care while in the hospital. It might include:
- Fluid replacement and nutrition. Because skin loss can result in loss of fluid from the body, it's vital to replace fluids and electrolytes. You might receive fluids and nutrients through a tube inserted in the nose and guided to the stomach (nasogastric tube).
- Wound care. Your health care team might gently cleanse the affected skin and apply special dressings infused with petroleum jelly (Vaseline) or medication. Your care team also monitors you for infection and gives you antibiotics if needed.
- Breathing help. You might need tests and procedures to evaluate your airway and help keep it clear. With advanced disease, you might need intubation or mechanical breathing assistance (ventilation).
- Pain control. You'll receive pain medicine to reduce your discomfort. For pain in your mouth, you might be given a mouthwash containing a numbing agent, such as lidocaine.
- Eye care. For mild eye symptoms, you might benefit from applying preservative-free artificial tears at least four times a day. Eye drops with corticosteroids might be used to control eye inflammation. Your care team might include an eye specialist (ophthalmologist).
Medications
Treatment of TEN also might include one or a combination of medications that affect the whole body (systemic drugs), such as cyclosporine (Neoral, Sandimmune), etanercept (Enbrel) and intravenous immunoglobulin (IVIG). Further study is needed to determine their benefit, if any.