Surgery>>>>>The Skin and Subcutaneous Tissue
Question 22#

Correct statements about toxic epidermal necrolysis (TEN) include all of the following EXCEPT:

A. Toxic epidermal necrolysis is believed to be an immunologic problem
B. Lesions are similar in appearance to partial thickness burns
C. The process develops at the dermo-epidermal junction
D. Corticosteroid use is a primary part of therapy

Correct Answer is D

Comment:

These inflammatory diseases represent a spectrum of an autoimmune reaction to stimuli such as drugs that result in structural defects in the epidermal-dermal junction. The cutaneous manifestations of toxic epidermal necrolysis syndrome (TENS) follow a prodromal period reminiscent of an upper respiratory tract infection. A symmetrical macular eruption follows starting from the face and trunk and spreading to the extremities. Typically, a Nikolsky sign develops in which lateral pressure causes the epidermis to detach from the basal layer. The macular eruption evolves into blisters, causing an extensive superficial partial-thickness skin injury with exposed dermis.