Pathology
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Atlas of dermatopathology
Josef Feit, Hana Jedličková, Günter Burg, Luděk Matyska, Spasoje Radovanovic et al.
Index
Contents
Authors
ExpSys: non-tumors
ExpSys: tumors
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+ Introduction
+ Literature
+ Support
+ Skin biopsy
+ Non-tumorous skin diseases
+ Skin tumors
+ Cysts of the skin and subcutis
+ Soft tissue lesions
+ Some lesions of the oral cavity
+ Dermatovenerology
+ Collection of histological slides by prof. Günter Burg
+ Collection of histological slides by prof. Werner Kempf
+ Collection of histological slides of dr. Ram Chandra Adhikari
Toxic epidermal necrolysis of Lyell
Clinical signs
  • the most severe drug eruption, TEN can affect up to 100% of the skin surface
  • multiform lesions, blisters, the epidermis peels off, leaving denuded areas
  • erosions and hemorrhagic crusts on the mucous membranes
  • Nikolsky's sign is positive
  • malaise, fever, loss of fluids, danger of infectious complications
  • life threatening disease
  • infectious etiology in some cases (staphyloccocus)
Pictures

Healing TEN (caused by cotrimoxazol) Drug reaction, Clinical picture (1136)

Toxic epidermal necrolysis of Lyell, loss of the epidermis in 99% of the body (autopsy case): Toxic epidermal necrolysis of Lyell, Macro, autopsy (2479) Toxic epidermal necrolysis of Lyell, Macro, autopsy (2480) Toxic epidermal necrolysis of Lyell, Macro, autopsy (2481)

Another case of TEN (caused by andidepressive drugs), autopsy: Lyell's syndrome, Macro, autopsy (6171) Lyell's syndrome, Macro, autopsy (6170) Lyell's syndrome, Macro, autopsy (6169) Lyell's syndrome, Macro, autopsy (6172) Lyell's syndrome, Macro, autopsy (6173)

Further examples of toxic epidermal necrolysis:

Histology

Necrosis of the whole epidermis, subepidermal bulla, dermo-epidermal separation.

Pictures

Toxic epidermal necrolysis of Lyell: Toxic epidermal necrolysis of Lyell, HE 2.5x (1428) Toxic epidermal necrolysis of Lyell, HE 10x (1894) Toxic epidermal necrolysis of Lyell, HE 20x (1431) Toxic epidermal necrolysis of Lyell, HE 40x (1432) Toxic epidermal necrolysis of Lyell, HE 40x (1429)

Another case: Toxic epidermal necrolysis, TEN, HE 20x (5264) Toxic epidermal necrolysis of Lyell, HE 10x (1425) Toxic epidermal necrolysis of Lyell, HE 20x (1426)

Another case: Toxic epidermal necrolysis, TEN, Lyell, HE 60x (12461) Toxic epidermal necrolysis, TEN, Lyell, HE 60x (12462)

Another case: Toxic epidermal necrolysis of Lyell, HE 10x (1433)

Another case, toxic epidermal necrolysis drug reaction: Toxic epidermal necrolysis, TEN, drug induced, HE 20x (4623)

Another case: Toxic epidermal necrolysis, TEN, HE 20x (4779)

Another case: Toxic epidermal necrolysis, TEN, HE 60x (12138)

Another case: Toxic epidermal necrolysis, TEN, HE 40x (13264)

Another case: Toxic epidermal necrolysis, TEN, HE 40x (6325)

Another case: Lyell syndrome, TEN, HE 60x (10993)

Another case; widespread necroses of the mucous layers and the skin after therapy for follicular lymphoma; the patient has dies soon after the second biopsy: Toxic epidermal necrolysis, TEN, HE 40x (6118) Toxic epidermal necrolysis of Lyell, HE 40x (6115)