Conditions and symptoms
What Is Toxic Epidermal Necrolysis (TEN)? A Skin Warning
Toxic Epidermal Necrolysis · say it: TOK-sik ep-ih-DUR-mul neh-KROL-ih-sisAlso written: TEN, Lyell's syndrome, SJS/TEN
Short answer
Toxic epidermal necrolysis (TEN) is a rare, life-threatening skin reaction, usually to a medicine, in which skin blisters and peels; it is an emergency.
What it means
Toxic epidermal necrolysis (TEN) is a rare but life-threatening reaction, most often caused by a medicine. The top layer of skin blisters and peels away in large areas, and the mouth, eyes and genitals can be badly affected. It often starts with fever and flu-like symptoms, then a painful red or purple rash. It needs emergency medical help, and the suspected medicine is stopped.
Labels list TEN together with Stevens-Johnson syndrome (SJS), which is a less extensive form of the same reaction. Medicines linked to it include some anti-seizure medicines, allopurinol, some sulfonamide antibiotics and some anti-inflammatory medicines. The warning is there so a new blistering rash, sores in the mouth or eyes, or peeling skin is treated as urgent, especially in the first weeks of a new medicine.
TEN is very different from a mild itchy rash, which is far more common. Still, any rash with blisters, skin pain, fever or mouth sores should be checked immediately.
Where you may see it
- Medicine labels under 'Serious skin reactions'
- Leaflets under 'Stop taking and get help immediately'
- Allergy records after a reaction
📄 How it looks on a report
Serious dermatologic reactions, including toxic epidermal necrolysis and Stevens-Johnson syndrome, have been reported.
🙅 What it does not mean
- Being listed on a label does not mean it is likely; it is rare.
- Not every rash is TEN; but blistering, peeling, skin pain or mouth sores need urgent care.
- After TEN, the cause should be recorded as an allergy so the medicine is never given again.
🗒️ Questions to ask your doctor
💊 Medicines whose labels mention “Toxic Epidermal Necrolysis”
Plain-English explanations of each medicine, from its official FDA label.
- Acyclovir
An antiviral medicine of the nucleoside analogue type, used against herpesviruses
- Allopurinol
a xanthine oxidase inhibitor, a prescription medicine that acts on uric acid
- Atenolol
a beta-blocker (beta-adrenergic blocker). The label describes it as a beta 1-selective, or cardioselective, blocking agent.
- Azithromycin
a macrolide antibacterial (antibiotic) medicine
- Carbamazepine
a mood stabilizer, and an anticonvulsant (seizure) medicine, according to the label
- Cephalexin
a cephalosporin antibacterial medicine (an antibiotic that treats bacterial infections)
- Doxycycline
a tetracycline-class antibacterial medicine (an antibiotic)
- Furosemide
A loop diuretic, a type of medicine that helps the body get rid of extra fluid through urine
- Hydrochlorothiazide
A thiazide diuretic, a type of medicine often called a 'water pill'
- Isoniazid
An antibacterial medicine of the antimycobacterial type, used against tuberculosis bacteria
🔗 Read more from trusted sources
- “Toxic Epidermal Necrolysis” on MedlinePlus ↗
US National Library of Medicine
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