RT Book, Section A1 Valeyrie-Allanore, L. A1 Roujeau, Jean-Claude A2 Goldsmith, Lowell A. A2 Katz, Stephen I. A2 Gilchrest, Barbara A. A2 Paller, Amy S. A2 Leffell, David J. A2 Wolff, Klaus SR Print(0) ID 56033128 T1 Chapter 40. Epidermal Necrolysis (Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis) T2 Fitzpatrick's Dermatology in General Medicine, 8e YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-166904-7 LK accessmedicine.mhmedical.com/content.aspx?aid=56033128 RD 2023/05/27 AB |PrintEpidermal Necrolysis at a GlanceRare and life-threatening reaction, mainly drug induced.Widespread apoptosis of keratinocytes provoked by the activation of a cell-mediated cytotoxic reaction and amplified by cytokines, mainly granulysin.Confluent purpuric and erythematous macules evolving to flaccid blisters and epidermal detachment predominating on the trunk and upper limbs and associated with mucous membrane involvement.Pathologic analysis shows full-thickness necrosis of epidermis associated with mild mononuclear cell infiltrate. A dozen “high-risk” drugs account for one half of cases.Up to 20% of cases remain idiopathic.Early identification and withdrawal of suspect drugs are essential for good patient outcome.Treatment is mainly symptomatic. Sequelae are nearly constant, needing systematic follow-up examinations.