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'''Flatulence Microchapters
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__NOTOC__
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{{flatuelnce}}
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{{CMG}}
[[Flatulence|Home]]
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==Overview==
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'''Toxic Epidermal Necrolysis''' is a life-threatening [[dermatology|dermatological]] condition that is frequently induced by a reaction to medications. It is characterized by the detachment of the top layer of skin (the [[epidermis]]) from the lower layers of the skin (the [[dermis]]) all over the body. There is broad agreement in the medical literature that TEN can be considered a more severe form of [[Stevens-Johnson syndrome]] and debate whether it falls on a spectrum of disease that includes [[erythema multiforme]].<ref>{{cite journal |author=Carrozzo M, Togliatto M, Gandolfo S |title=[Erythema multiforme. A heterogeneous pathologic phenotype] |journal=Minerva Stomatol|volume=48 |issue=5 |pages=217-26 |year=1999 |pmid=10434539}}</ref><ref>{{cite journal |author=Farthing P, Bagan J, Scully C |title=Mucosal disease series. Number IV. Erythema multiforme |journal=Oral Dis |volume=11 |issue=5 |pages=261-7 |year=2005 |pmid=16120111}}</ref>
[[Flatulence (patient information)|Patient Information]]
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==Pathophysiology==
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Microscopically, TEN causes [[cell death]] throughout the epidermis.  [[Keratinocytes]], which are the cells found lower in the dermis,  specialize in holding the skin cells together, undergo [[necrosis]] (uncontrolled cell death).
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==Causes==
[[Flatulence overview|Overview]]
Toxic epidermal necrolysis is a rare and usually severe adverse reaction to certain drugs. History of medication use exists in over 95% of patients with TEN. The drugs most often implicated in TEN are antibiotics such as sulfonamides, [[nonsteroidal anti-inflammatory drugs]], [[allopurinol]], [[antiretroviral drugs]], [[corticosteroids]] and[[anticonvulsant]]s such as [[phenobarbital]], [[phenytoin]], [[carbamazepine]], and [[valproic acid]].  The condition might also result from immunizations,  infection with agents such as ''[[Mycoplasma pneumoniae]]'' or  [[herpes virus]] and [[Organ transplant|transplant]]s of [[bone marrow]] or organs.
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==Epidemiology and Demographics==
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The [[incidence (epidemiology)|incidence]] is between 0.4 and 1.2 cases per 100,000 each year.
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==Natural History, Complications and Prognosis==
[[Flatulence pathophysiology|Pathophysiology]]
The mortality for toxic epidermal necrolysis is 30-40%.<ref name=garra>Garra, GP (2007). "[http://www.emedicine.com/EMERG/topic599.htm Toxic Epidermal Necrolysis]". Emedicine.com. Retrieved on December 13, 2007.</ref>  Loss of the skin leaves patients vulnerable to infections from fungi and bacteria, and can result in [[septicemia]], the leading cause of death in the disease.<ref name=garra/> Death is caused either by [[infection]] or by [[respiratory distress]] which is either due to [[pneumonia]] or damage to the linings of the airway. Microscopic analysis of tissue (especially the degree of dermal mononuclear inflammation and the degree of inflammation in general) can play a role in determining the prognosis of individual cases.<ref>{{cite journal |author=Quinn AM et al |title=Uncovering histological criteria with prognostic significance in toxic epidermal necrolysis |journal=Arch Dermatol |volume=141 |issue=6 |pages=683-7 |year=2005 |pmid=15967913}}</ref>
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==Diagnosis==
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===Laboratory Findings===
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Sometimes, however, examination of affected tissue under the microscope may be needed to distinguish it between other entities such as [[staphylococcal scalded skin syndrome]]. Typical histological criteria of TEN include mild infiltrate of lymphocytes which may obscure the dermoepidermal junction and prominent cell death with basal vacuolar change and individual cell necrosis.<ref>{{cite journal |author=Pereira FA, Mudgil AV, Rosmarin DM |title=flatuelnce |journal=J Am Acad Dermatol|volume=56 |issue=2 |pages=181-200 |year=2007 |pmid=17224365}}</ref>
[[Flatulence causes|Causes]]
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==References==
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{{reflist|2}}
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[[Category:Dermatology]]
[[Flatulence differential diagnosis|Differentiating Flatulence from other Diseases]]
[[Category:Medical emergencies]]
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[[Category:Emergency medicine]]
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[[Category:Disease]]


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{{WikiDoc Sources}}
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[[Flatulence epidemiology and demographics|Epidemiology and Demographics]]
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[[Flatulence risk factors|Risk Factors]]
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Diagnosis
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[[Flatulence history and symptoms|History and Symptoms]]
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[[Flatulence physical examination|Physical Examination]]
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[[Flatulence laboratory findings|Laboratory Findings]]
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[[Flatulence CT|CT]]
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[[Flatulence MRI|MRI]]
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[[Flatulence abdominal ultrasound|Abdominal Ultrasound]]
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[[Flatulence other imaging findings|Other Imaging Findings]]
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[[Flatulence other diagnostic studies|Other Diagnostic Studies]]
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Treatment
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[[Flatulence medical therapy|Medical Therapy]]
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[[Flatulence primary prevention|Primary Prevention]]
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[[Flatulence impact|Impact]]
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Case Studies
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[[Flatulence case study one|Case #1]]
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{{PAGENAME}} On the Web
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Latest revision as of 13:44, 10 April 2013

Flatulence Microchapters

Home

Patient Information

Overview

Pathophysiology

Causes

Differentiating Flatulence from other Diseases

Epidemiology and Demographics

Risk Factors

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Abdominal Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Impact

Case Studies

Case #1

Flatulence On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

[1]

American Roentgen Ray Society Images of Flatulence

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA onFlatulence

CDC on Flatulence

in the news

Blogs on Flatulence

Directions to Hospitals Treating Flatulence

Risk calculators and risk factors for Flatulence

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