Toxic epidermal necrolysis. Granulocytic leukopenia as a prognostic indicator

Abstract

Drug-induced toxic epidermal necrolysis is a disease of severe morbidity and high mortality. In the 10 cases reported, therapeutic measures, including antibiotics, closed mechanical ventilation, maintenance of fluid and electrolyte balance and management in special burn-care units, failed to alter a poor prognosis. The administration of corticosteroids was of no apparent benefit and may have been detrimental. Young age seemed to have a favorable influence on survival. There developed a pattern of leukopenia due to severe granulocytopenia that proved to be of prognostic importance. Persistence of the granulocytopenia portended a fatal outcome, whereas recovery of the granulocyte count to normal indicated, overall, a more favorable trend. The cause of the granulocytopenia could not be determined.