Complications

Early Complications

On average, death unfortunately still occurs in every third patient with TEN, and it is mainly due to infections (S. aureus and Pseudomonas aeruginosa). Massive transcutaneous fluid loss associated with electrolyte imbalance, inhibition of insulin secretion, insulin resistance, and the onset of a hypercatabolic state can also be contributive factors. All these complications of TEN (that can also be observed in SJS) are best managed in intensive care units. They can unfortunately culminate in adult respiratory distress syndrome and multiple organ failure despite adequate supportive therapy.

Long-term complications

Patients who survive the acute-phase of the disease may present sequelae such as symblepharon, conjunctival synechiae, entropion, ingrowth of eyelashes, cutaneous scarring, irregular pigmentation, eruptive melanocytic nevi, persistent erosions of the mucous membranes, phimosis, vaginal synechiae, nail dystrophy and diffuse hair loss. These can often be minimized by optimal skin care during the acute phase of the illness, but, in TEN, up to 35% of survivors can have been reported to suffer from ocular symptoms ranging from sicca syndrome to blindness.