Eitilfrumubólga

Eitilfrumubólga, known in English as toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), is a severe, life-threatening cutaneous adverse drug reaction. It is characterized by widespread epidermal necrosis and sloughing of mucous membranes. TEN and SJS are considered to be part of a spectrum of disease, with SJS being a less severe form.

The incidence of SJS/TEN is rare, but mortality rates are high, particularly for TEN. The condition is most commonly triggered by medications, with antibiotics, anticonvulsants, and nonsteroidal anti-inflammatory drugs being the most frequent culprits. Infections can also precipitate SJS/TEN, though drug-induced cases are more prevalent.

The onset of SJS/TEN is typically acute, following drug exposure by one to three weeks. Initial symptoms may include fever, sore throat, and malaise, preceding the characteristic rash. The rash often begins as erythematous or purpuric macules that rapidly coalesce and spread. Blistering and epidermal detachment are hallmark features, affecting large areas of the skin and mucous membranes, including the oral cavity, eyes, and genitalia.

Diagnosis is primarily clinical, supported by a skin biopsy showing full-thickness epidermal necrosis. Management involves immediate discontinuation of the suspected causative agent, supportive care including fluid and electrolyte management, wound care, pain control, and nutritional support. In severe cases, transfer to a burn unit may be necessary. While various treatments have been explored, including corticosteroids and intravenous immunoglobulin, their efficacy remains debated. Prevention relies on careful medication history taking and avoidance of known triggers.